Individual provider Active NPI

Jamie Jo Tegt, LCSW

  • Social Worker
  • Jefferson, WI
National Provider Identifier
1245690007
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
129554-121 Issued in WI
Practice address
1541 Annex Rd
Jefferson, WI 53549-9803
Phone
(920) 674-8103
NPI assigned
Mar 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 1449 WI
Social Worker 104100000X 129554-121 WI Primary

Addresses

Primary practice location

1541 Annex Rd
Jefferson, WI 53549-9803

Mailing address

1541 Annex Rd
Jefferson, WI 53549-9803
Phone (920) 674-8103

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL jamiet@jeffersoncountywi.gov Direct

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
129554-121WIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1245690007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 ANNEX RD",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535499803",
            "telephone_number": "920-674-8103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 ANNEX RD",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535499803",
            "telephone_number": "920-674-8103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEGT",
        "first_name": "JAMIE",
        "middle_name": "JO",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-07",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "1449",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "129554-121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "jamiet@jeffersoncountywi.gov",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1541 Annex Rd",
            "city": "Jefferson",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535499803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jefferson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.