Active NPI
Kenneth Everett Jeffery
- Clinical Social Worker
- New Bedford, MA
National Provider Identifier
1124317912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 52 Brigham St
Suite 5
New Bedford, MA 02740-2210 - Phone
- (508) 993-8332
- Fax
- (508) 993-1024
- NPI assigned
- Apr 1, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
52 Brigham St
Suite 5
New Bedford, MA 02740-2210
Mailing address
52 Brigham St
Suite 5
New Bedford, MA 02740-2210
Phone (508) 993-8332
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150821012746 | MA | Practitioner - Clinical Social Worker | 6103131081 | Practice locations: New Bedford, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2011
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
52 Brigham St
New Bedford, MA 02740-2210
Phone (508) 993-8332
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South County Psychiatry LLC | Clinical | 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": "1301616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430611200000",
"number": "1124317912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "52 BRIGHAM ST",
"address_2": "SUITE 5",
"city": "NEW BEDFORD",
"state": "MA",
"postal_code": "027402210",
"telephone_number": "508-993-8332",
"fax_number": "508-993-1024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "52 BRIGHAM ST",
"address_2": "SUITE 5",
"city": "NEW BEDFORD",
"state": "MA",
"postal_code": "027402210",
"telephone_number": "508-993-8332",
"fax_number": "508-993-1024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEFFERY",
"first_name": "KENNETH",
"middle_name": "EVERETT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-01",
"last_updated": "2015-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Bedford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.