Active NPI
Daniel E Jens, LISW
- Clinical Social Worker
- Bettendorf, IA
National Provider Identifier
1164410924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 03213
- Practice address
- 2485 Tech Dr
Bettendorf, IA 52722-3262 - Phone
- (563) 355-1611
- Fax
- (563) 355-6617
- NPI assigned
- Oct 6, 2005
- Last updated
- Jun 22, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 03213 | IA | Primary |
Addresses
Primary practice location
2485 Tech Dr
Bettendorf, IA 52722-3262
Mailing address
2485 Tech Dr
Bettendorf, IA 52722-3262
Phone (563) 355-1611
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03213 | IA | MD | Pain Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245628800000",
"number": "1164410924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2485 TECH DR",
"city": "BETTENDORF",
"state": "IA",
"postal_code": "527223262",
"telephone_number": "563-355-1611",
"fax_number": "563-355-6617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2485 TECH DR",
"city": "BETTENDORF",
"state": "IA",
"postal_code": "527223262",
"telephone_number": "563-355-1611",
"fax_number": "563-355-6617"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENS",
"first_name": "DANIEL",
"middle_name": "E",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-06",
"last_updated": "2009-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IA",
"license": "03213",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bettendorf, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.