Active NPI
Jacky Ann King
- Social Worker
- Payette, ID
National Provider Identifier
1134875974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 250 S Main St
Payette, ID 83661-2853 - Phone
- (208) 405-0020
- NPI assigned
- Mar 1, 2022
- Last updated
- Mar 1, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | |||
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
250 S Main St
Payette, ID 83661-2853
Mailing address
9 N 3Rd St W
Homedale, ID 83628-3133
Phone (208) 870-2729
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Insight Counseling & Therapy | Current | Accepting new patients | |
| Insight Matters, Inc | Social Worker | Current | Accepting new patients |
Locations
250 S Main St
Payette, ID 83661
Phone (208) 405-0020
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Social Worker
- Payette, ID
- NPI 1104350511
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646092800000",
"number": "1134875974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 N 3RD ST W",
"city": "HOMEDALE",
"state": "ID",
"postal_code": "836283133",
"telephone_number": "208-870-2729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 S MAIN ST",
"city": "PAYETTE",
"state": "ID",
"postal_code": "836612853",
"telephone_number": "208-405-0020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "JACKY",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-01",
"last_updated": "2022-03-01",
"certification_date": "2022-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Payette, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.