Individual provider Active NPI

Jennifer Dawn Newcomer, LCSW

  • Clinical Social Worker
  • Kansas City, MO
National Provider Identifier
1174510580
Registry record updated Dec 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2000168346 Issued in MO
Practice address
5775 NW 64TH Ter
Ste. 202
Kansas City, MO 64151-2382
Phone
(816) 505-3333
Fax
(816) 753-7744
NPI assigned
Sep 30, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CADC1 (PENDING) KS
Social Worker 104100000X 2156 KS
Social Worker 104100000X 2000168346 MO
Clinical Social Worker 1041C0700X 2000168346 MO Primary

Addresses

Primary practice location

5775 NW 64TH Ter
Ste. 202
Kansas City, MO 64151-2382

Mailing address

4602 NE 83Rd Ter
Kansas City, MO 64119-7617
Phone (816) 529-5990

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

LicenseStateTypeSpecialty
CADC1 (PENDING)KSMDAddiction (Substance Use Disorder) Counselor
2000168346MOMDSocial Worker
2156KSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatry Associates of Kansas City PA Past Accepting new patients
Wubbenhorst & Wubbenhorst, Inc. Addiction (Substance Use Disorder) Past Accepting new patients
Journeys Past Accepting new patients
Northland Psychological Associates LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418601600000",
    "number": "1174510580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4602 NE 83RD TER",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641197617",
            "telephone_number": "816-529-5990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5775 NW 64TH TER",
            "address_2": "STE. 202",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641512382",
            "telephone_number": "816-505-3333",
            "fax_number": "816-753-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWCOMER",
        "first_name": "JENNIFER",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2014-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "CADC1 (PENDING)",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "2156",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2000168346",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2000168346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; 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.