Individual provider Active NPI

Marcia Beard Jaudon, LCSW

  • Clinical Social Worker
  • Blacksburg, VA
National Provider Identifier
1154305381
Registry record updated Jan 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904004886 Issued in VA
Practice address
200 Country Club Dr SW
Suite D-2
Blacksburg, VA 24060-5400
Phone
(540) 772-8043
Fax
(540) 772-8242
NPI assigned
Dec 1, 2005
Last updated
Jan 27, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2010

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 0904004886 VA Primary

Addresses

Primary practice location

200 Country Club Dr SW
Suite D-2
Blacksburg, VA 24060-5400

Mailing address

4346 Starkey Rd
Suite 1
Roanoke, VA 24018-0605
Phone (540) 772-8043

Other identifiers 6

IdentifierTypeStateIssuer
273010000OtherVAMAGELLAN
434471OtherVABLUE CROSS BLUE SHIELD
7454323OtherVAAETNA
517355OtherVAVALUE OPTIONS
801058OtherVASOUTHERN HEALTH
008931305MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160804000484 GA Practitioner - Clinical Social Worker 8921061367 Practice locations: Dalton, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Baylor College of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

109 W Morris St
Dalton, GA 30720-8401
Phone (706) 452-7056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1154305381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4346 STARKEY RD",
            "address_2": "SUITE 1",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240180605",
            "telephone_number": "540-772-8043",
            "fax_number": "540-772-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 COUNTRY CLUB DR SW",
            "address_2": "SUITE D-2",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240605400",
            "telephone_number": "540-772-8043",
            "fax_number": "540-772-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAUDON",
        "first_name": "MARCIA",
        "middle_name": "BEARD",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-01",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904004886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "273010000",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "434471",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7454323",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "517355",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "801058",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008931305",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacksburg, VA

Sources for this page

Verify at the official NPI Registry.