Individual provider Active NPI

Jody Tabner Thayer, LCSW-C

  • Clinical Social Worker
  • Rockville, MD
National Provider Identifier
1174872964
Registry record updated Mar 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14974 Issued in MD
Practice address
15701 Crabbs Branch Way
Rockville, MD 20855-2634
Phone
(301) 251-8965
NPI assigned
Sep 7, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2017

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 14974 MD Primary

Addresses

Primary practice location

15701 Crabbs Branch Way
Rockville, MD 20855-2634

Mailing address

15701 Crabbs Branch Way
Rockville, MD 20855-2634
Phone (301) 251-8965

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20121207000331 DC Practitioner - Clinical Social Worker 5991957474 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4401 E W Hwy
Suite 301
Bethesda, MD 20814-4562
Phone (301) 793-9600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jody Tabner Thayer LLC Clinical CurrentSince May 17, 2019 Accepting new patients

Locations

4401 East West Hwy
Ste 301
Bethesda, MD 20814
Phone (301) 656-3410

15701 Crabbs Branch Way
Rockville, MD 20855
Phone (301) 251-8965

Organizations & group practices 2

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": "1346976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490918400000",
    "number": "1174872964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15701 CRABBS BRANCH WAY",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208552634",
            "telephone_number": "301-251-8965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15701 CRABBS BRANCH WAY",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208552634",
            "telephone_number": "301-251-8965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAYER",
        "first_name": "JODY",
        "middle_name": "TABNER",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-07",
        "last_updated": "2017-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "14974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.