Active NPI
Kristin Lee Jamba
- Social Worker
- Binghamton, NY
National Provider Identifier
1164702379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 092836
- Practice address
- 257 Main St
Binghamton, NY 13905-2522 - Phone
- (607) 729-6206
- Fax
- (607) 729-1858
- NPI assigned
- Aug 18, 2011
- Last updated
- Aug 28, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 092836 | NY | Primary |
Addresses
Primary practice location
257 Main St
Binghamton, NY 13905-2522
Mailing address
257 Main St
Binghamton, NY 13905-2522
Phone (607) 729-6206
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251205001351 | NY | Order and Referring Only - Clinical Social Worker | 1052804234 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 092836 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409184000000",
"number": "1164702379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "257 MAIN ST",
"city": "BINGHAMTON",
"state": "NY",
"postal_code": "139052522",
"telephone_number": "607-729-6206",
"fax_number": "607-729-1858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "257 MAIN ST",
"city": "BINGHAMTON",
"state": "NY",
"postal_code": "139052522",
"telephone_number": "607-729-6206",
"fax_number": "607-729-1858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAMBA",
"first_name": "KRISTIN",
"middle_name": "LEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-18",
"last_updated": "2014-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "092836",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Binghamton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.