Organization Active NPI

Jewish Family Service Inc

  • Clinical Social Worker
  • Memphis, TN
National Provider Identifier
1104875764
Registry record updated Jun 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
JEWISH FAMILY SERVICE INC
Practice address
6560 Poplar Ave
Suite B
Memphis, TN 38138-3656
Phone
(901) 767-8511
Fax
(901) 763-2348
NPI assigned
May 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2013

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

Authorized official

Name
Mark Hendren
Title
Insurance Administrator
Phone
(901) 767-8511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

6560 Poplar Ave
Suite B
Memphis, TN 38138-3656

Mailing address

6560 Poplar Ave
Suite B
Memphis, TN 38138-3656
Phone (901) 767-8511

Other identifiers 2

IdentifierTypeStateIssuer
3007926OtherTNBLUE CROSS BLUE SHIELD
3719934MedicaidTN

National Provider Directory

National Provider Directory

Locations

6560 Poplar Ave
Ste B
Memphis, TN 38138
Phone (901) 767-8511

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371600000000",
    "number": "1104875764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6560 POPLAR AVE",
            "address_2": "SUITE B",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381383656",
            "telephone_number": "901-767-8511",
            "fax_number": "901-763-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6560 POPLAR AVE",
            "address_2": "SUITE B",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381383656",
            "telephone_number": "901-767-8511",
            "fax_number": "901-763-2348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEWISH FAMILY SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2013-06-19",
        "status": "A",
        "authorized_official_last_name": "HENDREN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "INSURANCE ADMINISTRATOR",
        "authorized_official_telephone_number": "901-767-8511"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3007926",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3719934",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2013; 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.