Individual provider Active NPI

Jeanne Deangelis Jennings, LMSW

  • Social Worker
  • Kingston, NY
National Provider Identifier
1205019379
Registry record updated Dec 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
031575 Issued in NY
Practice address
Ugarc Ulster Rehab Clinic
139 Cornell St
Kingston, NY 12401
Phone
(845) 338-1234
Fax
(845) 338-6284
NPI assigned
Dec 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2007

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 031575 NY Primary

Addresses

Primary practice location

Ugarc Ulster Rehab Clinic
139 Cornell St
Kingston, NY 12401

Mailing address

Ugarc Ulster Rehab Clinic
139 Cornell St
Kingston, NY 12401
Phone (845) 338-1234

Other identifiers 1

IdentifierTypeStateIssuer
031575OtherNYLICENSE

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
031575NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nysarc Inc. Ulster, Greene, Putnam Counties Chapter PastSince Oct 12, 2015 Accepting new patients
Hudson Valley Health Specialties, Inc Past Accepting new patients

Organizations & group practices 2

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": "1197417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197417600000",
    "number": "1205019379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UGARC ULSTER REHAB CLINIC",
            "address_2": "139 CORNELL ST",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "12401",
            "telephone_number": "845-338-1234",
            "fax_number": "845-338-6284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UGARC ULSTER REHAB CLINIC",
            "address_2": "139 CORNELL ST",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "12401",
            "telephone_number": "845-338-1234",
            "fax_number": "845-338-6284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "JEANNE",
        "middle_name": "DEANGELIS",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-12",
        "last_updated": "2007-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "031575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "031575",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; 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.