Individual provider Active NPI

Jeremy Floyd, LCSW

  • Clinical Social Worker
  • Salem, VA
National Provider Identifier
1154078780
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904013737 Issued in VA
Practice address
1970 Roanoke Blvd
Salem, VA 24153-6478
Phone
(540) 982-2463
NPI assigned
Mar 3, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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 0904013737 VA Primary

Addresses

Primary practice location

1970 Roanoke Blvd
Salem, VA 24153-6478

Mailing address

1945 Connors CT
Salem, VA 24153-7441
Phone (434) 857-6585

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
0904013737VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1646265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1154078780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 CONNORS CT",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537441",
            "telephone_number": "434-857-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 ROANOKE BLVD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241536478",
            "telephone_number": "540-982-2463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOYD",
        "first_name": "JEREMY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-03",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904013737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.

Verify at the official NPI Registry.