Jane Neikirk Edgell

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

004592 Issued in CT

Practice address

212 Ellsworth St
Bridgeport, CT 06605-3124

Phone

(917) 838-2535

NPI assigned

Jan 3, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1215640586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 ELLSWORTH ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066053124",
            "telephone_number": "917-838-2535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 ELLSWORTH ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066053124",
            "telephone_number": "917-838-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGELL",
        "first_name": "JANE",
        "middle_name": "NEIKIRK",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-03",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Dziubina, PA-C
• Helen Dzujna, P.A.C
• Florence Ebbecke
• Melissa Ebdon, RD
• Eclectic Physical Therapy LLC
• Kristin L. Edgerton
• Edward M Lane MD PC
• Kimberly Edwards, PT
• Nicole Danielle Edwards, D.D.S.
• Taylor Sophia Edwards, PA-C

• Clinical Social Worker in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.