NPIMap

Individual provider Active NPI

Jamie Terry, LLMSW, QMRP

  • Social Worker
  • Flint, MI
National Provider Identifier
1215374269
Registry record updated May 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801090262 Issued in MI
Practice address
5095 Van Slyke Rd
Flint, MI 48507-3959
Phone
(810) 234-7080
Fax
(810) 235-4999
NPI assigned
May 31, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2013

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 6801090262 MI Primary

Addresses

Primary practice location

5095 Van Slyke Rd
Flint, MI 48507-3959

Mailing address

5095 Van Slyke Rd
Flint, MI 48507-3959
Phone (810) 234-7080

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
6801090262MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Group Living Facilities Non-Profit Housing Corporation Past Accepting new patients
New Century Support Services 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": "1369958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369958400000",
    "number": "1215374269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5095 VAN SLYKE RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073959",
            "telephone_number": "810-234-7080",
            "fax_number": "810-235-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5095 VAN SLYKE RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073959",
            "telephone_number": "810-234-7080",
            "fax_number": "810-235-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "JAMIE",
        "credential": "LLMSW, QMRP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-31",
        "last_updated": "2013-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801090262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2013; 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.