Individual provider Active NPI

Jeremy Paul Darden

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1174920235
Registry record updated Feb 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14857 Issued in MD
Practice address
2500 Fait Ave
Baltimore, MD 21224-3719
Phone
(410) 209-7275
NPI assigned
Dec 4, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2016

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 14857 MD Primary

Addresses

Primary practice location

2500 Fait Ave
Baltimore, MD 21224-3719

Mailing address

8517 Greens LN
Baltimore, MD 21244-1124
Phone (410) 209-7275

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
14857MDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1417651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455321600000",
    "number": "1174920235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8517 GREENS LN",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212441124",
            "telephone_number": "410-209-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 FAIT AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212243719",
            "telephone_number": "410-209-7275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARDEN",
        "first_name": "JEREMY",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-04",
        "last_updated": "2016-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "14857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2016; 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.