Individual provider Active NPI

Jeri Hautzig

  • Social Worker
  • East Chatham, NY
National Provider Identifier
1194533182
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
231273 Issued in MA
Practice address
PO Box 295
East Chatham, NY 12060-0295
Phone
(518) 567-2549
NPI assigned
Dec 21, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 231273 MA Primary

Addresses

Primary practice location

PO Box 295
East Chatham, NY 12060-0295

Mailing address

PO Box 295
East Chatham, NY 12060-0295
Phone (518) 567-2549

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
231273MAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1734739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1194533182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 295",
            "city": "EAST CHATHAM",
            "state": "NY",
            "postal_code": "120600295",
            "telephone_number": "518-567-2549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 295",
            "city": "EAST CHATHAM",
            "state": "NY",
            "postal_code": "120600295",
            "telephone_number": "518-567-2549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUTZIG",
        "first_name": "JERI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-21",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "231273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Chatham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.