Individual provider Active NPI

Jade Milliman, LCSW

  • Clinical Social Worker
  • Fort Wayne, IN
National Provider Identifier
1215693924
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34008955A Issued in IN
Practice address
2712 S Calhoun St
Fort Wayne, IN 46807-1402
Phone
(260) 744-4326
Fax
(260) 744-0188
NPI assigned
Nov 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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 34008955A IN Primary

Addresses

Primary practice location

2712 S Calhoun St
Fort Wayne, IN 46807-1402

Mailing address

2712 S Calhoun St
Fort Wayne, IN 46807-1402
Phone (260) 744-4326

Other names 1

  • Jade Pressler Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20211215001314 IN Practitioner - Clinical Social Worker 4082005608 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RDR Devine LLCGroup PAC ID 9931515889, 11 clinicians

Practice addresses (Care Compare)

6157 Stoney Creek Dr
Fort Wayne, IN 46825-4409
Phone (260) 570-4518

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family & Childrens Service of Fort Wayne Inc CurrentSince Nov 18, 2021 Accepting new patients

Locations

2712 S Calhoun St
Fort Wayne, IN 46807
Phone (219) 744-4326

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1215693924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2712 S CALHOUN ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468071402",
            "telephone_number": "260-744-4326",
            "fax_number": "260-744-0188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2712 S CALHOUN ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468071402",
            "telephone_number": "260-744-4326",
            "fax_number": "260-744-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLIMAN",
        "first_name": "JADE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-17",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008955A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JADE",
            "last_name": "PRESSLER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.