Individual provider Active NPI

Jahnae Nicole Roberts

  • Social Worker
  • Wampsville, NY
National Provider Identifier
1134732944
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
138 N Court St
Wampsville, NY 13163-7714
Phone
(315) 366-2327
NPI assigned
Aug 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 113258-01 NY
Social Worker 104100000X NY Primary

Addresses

Primary practice location

138 N Court St
Wampsville, NY 13163-7714

Mailing address

138 N Court St
Wampsville, NY 13163-7714
Phone (315) 366-2327

Other practice location 1

624 Elizabeth St
Utica, NY 13501-2413
Phone (315) 272-2600

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

State licenses

LicenseStateTypeSpecialty
113258-01NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Neighborhood Center, Inc. CurrentSince Dec 24, 2023 Accepting new patients

Locations

624 Elizabeth St
Utica, NY 13501
Phone (315) 272-2600

Interoperability endpoints

  • Direct secure messaging: jahnae.roberts@mcmh.medentdirect.com

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": "1598832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1134732944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 N COURT ST",
            "city": "WAMPSVILLE",
            "state": "NY",
            "postal_code": "131637714",
            "telephone_number": "315-366-2327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 N COURT ST",
            "city": "WAMPSVILLE",
            "state": "NY",
            "postal_code": "131637714",
            "telephone_number": "315-366-2327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "624 Elizabeth St",
            "address_purpose": "LOCATION",
            "city": "Utica",
            "state": "NY",
            "postal_code": "135012413",
            "country_code": "US",
            "telephone_number": "315-272-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JAHNAE",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-31",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "113258-01",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wampsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; 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.