Active NPI
Jackie Bounds
- Social Worker
- Buckner, MO
National Provider Identifier
1194277020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 2016029134
- Practice address
- 324 S Hudson St
Buckner, MO 64016-8142 - Phone
- (877) 344-3572
- Fax
- (660) 251-0524
- NPI assigned
- Oct 26, 2016
- Last updated
- Oct 26, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 2016029134 | MO | Primary |
Addresses
Primary practice location
324 S Hudson St
Buckner, MO 64016-8142
Mailing address
825 S Business Highway 13
Lexington, MO 64067-1515
Phone (660) 259-2440
Other names 1
- Jackie Roberts
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2016029134 | MO | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477440000000",
"number": "1194277020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "825 S BUSINESS HIGHWAY 13",
"city": "LEXINGTON",
"state": "MO",
"postal_code": "640671515",
"telephone_number": "660-259-2440",
"fax_number": "660-251-0524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "324 S HUDSON ST",
"city": "BUCKNER",
"state": "MO",
"postal_code": "640168142",
"telephone_number": "877-344-3572",
"fax_number": "660-251-0524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUNDS",
"first_name": "JACKIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-26",
"last_updated": "2016-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MO",
"license": "2016029134",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JACKIE",
"last_name": "ROBERTS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Buckner, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.