Individual provider Active NPI

Jodi L Ippolito, L.C.S.W.

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1205990231
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW015185 Issued in PA
Practice address
313 S 16TH St
Philadelphia, PA 19102-4908
Phone
(215) 732-8244
NPI assigned
Dec 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 CW015185 PA Primary

Addresses

Primary practice location

313 S 16TH St
Philadelphia, PA 19102-4908

Mailing address

305 E Upsal St
Philadelphia, PA 19119-2348
Phone (267) 974-4259

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
CW015185PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mazzoni Center PastSince Jan 1, 2007 Accepting new patients
Philadelphia School of Psychoanalysis Clinical Past Accepting new patients
Jefferson University Physicians Past Accepting new patients

Organizations & group practices 3

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": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205990231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 E UPSAL ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191192348",
            "telephone_number": "267-974-4259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 S 16TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024908",
            "telephone_number": "215-732-8244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IPPOLITO",
        "first_name": "JODI",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW015185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.