Individual provider Active NPI

Jayme M Mavrovich

  • Clinical Social Worker
  • Topeka, KS
National Provider Identifier
1144869025
Registry record updated Dec 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9293 Issued in KS
Practice address
2200 SW Gage Blvd
Topeka, KS 66622-0001
Phone
(785) 350-3111
NPI assigned
Dec 25, 2019
Last updated
Dec 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9293 KS Primary

Addresses

Primary practice location

2200 SW Gage Blvd
Topeka, KS 66622-0001

Mailing address

2200 SW Gage Blvd
Topeka, KS 66622-0001
Phone (785) 350-3111

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Topeka

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
9293KSMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1577232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577232000000",
    "number": "1144869025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 SW GAGE BLVD",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666220001",
            "telephone_number": "785-350-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 SW GAGE BLVD",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666220001",
            "telephone_number": "785-350-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAVROVICH",
        "first_name": "JAYME",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-25",
        "last_updated": "2019-12-25",
        "certification_date": "2019-12-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "9293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Topeka",
            "affiliation": "N",
            "address_1": "2200 SW Gage Blvd",
            "city": "Topeka",
            "state": "KS",
            "country_code": "US",
            "postal_code": "666220001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Topeka, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 2019; 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.