Individual provider Active NPI

Jennie Angela Poma-Jones, LCSW

  • Clinical Social Worker
  • St Augustine, FL
National Provider Identifier
1194313718
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW12238 Issued in FL
Practice address
28 Kingstown CT
Saint Augustine, FL 32092-3213
Phone
(586) 876-5549
NPI assigned
Jan 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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 SW12238 FL Primary

Addresses

Primary practice location

28 Kingstown CT
Saint Augustine, FL 32092-3213

Mailing address

28 Kingstown CT
Saint Augustine, FL 32092-3213
Phone (586) 876-5549

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210322000670 FL Practitioner - Clinical Social Worker 4789091612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Assessment and Counseling IncGroup PAC ID 8426235953, 3 clinicians

Practice addresses (Care Compare)

Jacksonville, FL 32219
Phone (352) 494-6857

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW12238FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Assessment and Counseling Inc Clinical CurrentSince May 20, 2024 Accepting new patients

Organizations & group practices 1

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": "1610064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1194313718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 KINGSTOWN CT",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320923213",
            "telephone_number": "586-876-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 KINGSTOWN CT",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320923213",
            "telephone_number": "586-876-5549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POMA-JONES",
        "first_name": "JENNIE",
        "middle_name": "ANGELA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-08",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.