Individual provider Active NPI

Jessica S Manning, L.I.C.S.W.

  • Clinical Social Worker
  • Portsmouth, RI
National Provider Identifier
1194837898
Registry record updated Jan 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW01902 Issued in RI
Practice address
3047 E Main Rd
Suite 7B
Portsmouth, RI 02871-4263
Phone
(401) 935-9041
Fax
(401) 683-0753
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2015

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 ISW01902 RI Primary

Addresses

Primary practice location

3047 E Main Rd
Suite 7B
Portsmouth, RI 02871-4263

Mailing address

PO Box 671
Portsmouth, RI 02871-0671
Phone (401) 935-9041

Other identifiers 1

IdentifierTypeStateIssuer
JM55185MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20101028000493 RI Practitioner - Clinical Social Worker 5496949067 Practice locations: Portsmouth, RI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3047 E Main Rd
Suite 7B
Portsmouth, RI 02871-4262
Phone (401) 935-9041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420243200000",
    "number": "1194837898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 671",
            "city": "PORTSMOUTH",
            "state": "RI",
            "postal_code": "028710671",
            "telephone_number": "401-935-9041",
            "fax_number": "401-683-0753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3047 E MAIN RD",
            "address_2": "SUITE 7B",
            "city": "PORTSMOUTH",
            "state": "RI",
            "postal_code": "028714263",
            "telephone_number": "401-935-9041",
            "fax_number": "401-683-0753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "JESSICA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW01902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "JM55185",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, RI

Sources for this page

Verify at the official NPI Registry.