Individual provider Active NPI

Jana Beth Vink, LMSW

  • Social Worker
  • Pella, IA
National Provider Identifier
1134465073
Registry record updated Dec 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
007955 Issued in IA
Practice address
404 Jefferson St
Pella, IA 50219-1257
Phone
(641) 628-3150
Fax
(641) 628-7241
NPI assigned
Dec 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2012

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 007955 IA Primary

Addresses

Primary practice location

404 Jefferson St
Pella, IA 50219-1257

Mailing address

404 Jefferson St
Pella, IA 50219-1257
Phone (641) 628-3150

Other identifiers 1

IdentifierTypeStateIssuer
007955OtherIAIOWA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 1, 2019 through Jan 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007955IAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Counseling, Inc. Current 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": "1356048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356048000000",
    "number": "1134465073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 JEFFERSON ST",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502191257",
            "telephone_number": "641-628-3150",
            "fax_number": "641-628-7241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 JEFFERSON ST",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502191257",
            "telephone_number": "641-628-3150",
            "fax_number": "641-628-7241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINK",
        "first_name": "JANA",
        "middle_name": "BETH",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-21",
        "last_updated": "2012-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "007955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA LICENSE",
            "identifier": "007955",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pella, IA

Sources for this page

Verify at the official NPI Registry.