Individual provider Active NPI

Anna Jenner, LSW

  • Social Worker
  • Vincennes, IN
National Provider Identifier
1104348713
Registry record updated May 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1901 Willow St
Vincennes, IN 47591-4277
Phone
(812) 885-2720
Fax
(812) 885-2723
NPI assigned
Jul 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

1901 Willow St
Vincennes, IN 47591-4277

Mailing address

515 Bayou St
Vincennes, IN 47591-1034
Phone (812) 886-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201102002189 IL Practitioner - Clinical Social Worker 0345650313 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Human Services CurrentSince Nov 18, 2021 Accepting new patients

Locations

1200 N 4th St
Effingham, IL 62401
Phone (217) 347-7179

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": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1104348713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 BAYOU ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911034",
            "telephone_number": "812-886-6800",
            "fax_number": "812-886-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 WILLOW ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475914277",
            "telephone_number": "812-885-2720",
            "fax_number": "812-885-2723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNER",
        "first_name": "ANNA",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-14",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vincennes, IN

Sources for this page

Verify at the official NPI Registry.