Individual provider Active NPI

Kristin Saunders, MSSW

  • Clinical Social Worker
  • Jacksonville, FL
National Provider Identifier
1093881096
Registry record updated Aug 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1100 Cesery Blvd
Suite 100
Jacksonville, FL 32211
Phone
(904) 745-3070
Fax
(904) 745-3087
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

1100 Cesery Blvd
Suite 100
Jacksonville, FL 32211

Mailing address

4083 Sunbeam Rd
2421
Jacksonville, FL 32257-8993

Other identifiers 1

IdentifierTypeStateIssuer
007650100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Child Guidance Center, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533513600000",
    "number": "1093881096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4083 SUNBEAM RD",
            "address_2": "2421",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322578993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CESERY BLVD",
            "address_2": "SUITE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32211",
            "telephone_number": "904-745-3070",
            "fax_number": "904-745-3087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUNDERS",
        "first_name": "KRISTIN",
        "name_prefix": "Ms.",
        "credential": "MSSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2018-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007650100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.