Individual provider Active NPI

Margaret Diane Jamrog

  • Clinical Social Worker
  • Midland, MI
National Provider Identifier
1265879886
Registry record updated May 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801091537 Issued in MI
Practice address
218 Fast Ice Dr
Midland, MI 48642-6167
Phone
(989) 631-2320
NPI assigned
May 23, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2013

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 6801091537 MI Primary

Addresses

Primary practice location

218 Fast Ice Dr
Midland, MI 48642-6167

Mailing address

3807 Chestnut Hill Dr
Midland, MI 48642-6208
Phone (616) 240-8574

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20131106000801 MI Practitioner - Clinical Social Worker 4385879998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Mental Health for Central MichiganGroup PAC ID 4688660533, 44 clinicians

Practice addresses (Care Compare)

655 E Cedar Ave
Gladwin, MI 48624-2215
Phone (989) 426-9295

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Mental Health for Central Michigan Clinical CurrentSince Aug 4, 2013 Accepting new patients

Locations

655 E Cedar Ave
Gladwin, MI 48624
Phone (989) 426-9295

218 Fast Ice Dr
Midland, MI 48642
Phone (989) 631-2320

301 S Crapo St
Ste 1
Mount Pleasant, MI 48858

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1369267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369267200000",
    "number": "1265879886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3807 CHESTNUT HILL DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486426208",
            "telephone_number": "616-240-8574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 FAST ICE DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486426167",
            "telephone_number": "989-631-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMROG",
        "first_name": "MARGARET",
        "middle_name": "DIANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-23",
        "last_updated": "2013-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801091537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.