Individual provider Active NPI

Jamie Garry

  • Clinical Social Worker
  • Tampa, FL
National Provider Identifier
1205315926
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801114710 Issued in MI
Practice address
5100 W Kennedy Blvd Ste 160
Tampa, FL 33609-1817
Phone
(813) 935-4145
Fax
(813) 935-0550
NPI assigned
Aug 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X 6801114710 MI Primary

Addresses

Primary practice location

5100 W Kennedy Blvd Ste 160
Tampa, FL 33609-1817

Mailing address

3577 SW Corporate Pkwy
Palm City, FL 34990-8153
Phone (813) 777-0259

Other practice location 1

3577 SW Corporate Pkwy
Palm City, FL 34990-8153
Phone (813) 777-0259

Other practice location 2

920 Diana St
Ludington, MI 49431-1987
Phone (231) 845-6294

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20220811002380 MI Practitioner - Clinical Social Worker 4284012360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

920 Diana St
Ludington, MI 49431-1987
Phone (231) 845-6294

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1205315926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3577 SW CORPORATE PKWY",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349908153",
            "telephone_number": "813-777-0259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W KENNEDY BLVD STE 160",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336091817",
            "telephone_number": "813-935-4145",
            "fax_number": "813-935-0550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3577 SW Corporate Pkwy",
            "address_purpose": "LOCATION",
            "city": "Palm City",
            "state": "FL",
            "postal_code": "349908153",
            "country_code": "US",
            "telephone_number": "813-777-0259",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "920 Diana St",
            "address_purpose": "LOCATION",
            "city": "Ludington",
            "state": "MI",
            "postal_code": "494311987",
            "country_code": "US",
            "telephone_number": "231-845-6294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARRY",
        "first_name": "JAMIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801114710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.