Active NPI
Jessie Jean Petkus, LSW
- Social Worker
- Taunton, MA
National Provider Identifier
1265622880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 1 Taunton GRN
Taunton, MA 02780-3225 - Phone
- (508) 822-4027
- NPI assigned
- Jul 30, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
1 Taunton GRN
Taunton, MA 02780-3225
Mailing address
22 Durant Rd
S Weymouth, MA 02190-2751
Phone (781) 340-5144
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185753600000",
"number": "1265622880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 DURANT RD",
"city": "S WEYMOUTH",
"state": "MA",
"postal_code": "021902751",
"telephone_number": "781-340-5144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 TAUNTON GRN",
"city": "TAUNTON",
"state": "MA",
"postal_code": "027803225",
"telephone_number": "508-822-4027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETKUS",
"first_name": "JESSIE JEAN",
"name_prefix": "Mrs.",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-30",
"last_updated": "2007-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taunton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.