Active NPI
Jessica Rainey Roberson, LMSW
- Social Worker
- Beech Island, SC
National Provider Identifier
1194490896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 12905
- Practice address
- 4645 Augusta Rd
Beech Island, SC 29842-7265 - Phone
- (803) 380-7000
- NPI assigned
- Aug 13, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 | 12905 | SC | Primary |
Addresses
Primary practice location
4645 Augusta Rd
Beech Island, SC 29842-7265
Mailing address
1000 Clyburn PL
Aiken, SC 29801-4193
Phone (803) 380-7000
Other names 1
- Jessica Erin Rainey
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12905 | SC | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628812800000",
"number": "1194490896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 CLYBURN PL",
"city": "AIKEN",
"state": "SC",
"postal_code": "298014193",
"telephone_number": "803-380-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4645 AUGUSTA RD",
"city": "BEECH ISLAND",
"state": "SC",
"postal_code": "298427265",
"telephone_number": "803-380-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERSON",
"first_name": "JESSICA",
"middle_name": "RAINEY",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-13",
"last_updated": "2021-08-13",
"certification_date": "2021-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker",
"state": "SC",
"license": "12905",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "RAINEY",
"middle_name": "ERIN",
"credential": "LMSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Beech Island, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.