Jeremy Wayne Irvin, LCSW, MED

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-36060 Issued in ID

Practice address

6003 W Overland Rd Ste 105
Boise, ID 83709-3075

Phone

(208) 417-8428

Fax

(208) 216-1434

NPI assigned

Apr 19, 2016

Sex

Male

Sole proprietor

No

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 ID

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

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

Practice roles

Locations

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.

• Idaho Institute of Gender and Sex Therapy

  • Clinical Social Worker
  • Boise, ID
  • NPI 1811451438
  Medicare reassignment NPD Authorized official
• Access Behavioral Health Services

  • Community/Behavioral Health Agency
  • Boise, ID
  • NPI 1487700589
  Medicare reassignment NPD
• Access Behavioral Health Services, Inc

  • Primary Care Clinic/Center
  • Boise, ID
  • NPI 1932506508
  NPD

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

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1245684927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3278 E RENWICK ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426467",
            "telephone_number": "208-417-8428",
            "fax_number": "208-216-1434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6003 W OVERLAND RD STE 105",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837093075",
            "telephone_number": "208-417-8428",
            "fax_number": "208-216-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRVIN",
        "first_name": "JEREMY",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "LCSW, MED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-19",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-36060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melannee Ipsen
• Iris Interpreting, LLC.
• Barbara L Irish, N.P.
• Caroline Pruitt Irons
• Ironwood Surgical PLLC
• Taylor Jane Irvin
• Andrew Matthews Irwin, MD
• Christine Dee Isaacs, PHD
• Heidi Isaacs
• Kimberly Isaacs, PHARMD

• Clinical Social Worker in Boise, ID
• Providers in Boise, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.