Individual provider Active NPI

Jamie Ricker, LCSW

  • Clinical Social Worker
  • Meriden, CT
National Provider Identifier
1275878563
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
008114 Issued in CT
Practice address
134 State St
Meriden, CT 06450-3293
Phone
(203) 237-2229
Fax
(203) 686-1677
NPI assigned
Nov 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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 008114 CT Primary

Addresses

Primary practice location

134 State St
Meriden, CT 06450-3293

Mailing address

575 Main St FL 2
Attn: Credentialing Dept
Middletown, CT 06457-2845
Phone (860) 347-6971

Other identifiers 1

IdentifierTypeStateIssuer
004236338MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20140312000096 CT Order and Referring Only - Clinical Social Worker 5597995670

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008114CTMDClinical Social Worker

Interoperability endpoints

  • Direct secure messaging: jamie.ricker@chcict.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1354060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354060800000",
    "number": "1275878563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 MAIN ST FL 2",
            "address_2": "ATTN: CREDENTIALING DEPT",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572845",
            "telephone_number": "860-347-6971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 STATE ST",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064503293",
            "telephone_number": "203-237-2229",
            "fax_number": "203-686-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKER",
        "first_name": "JAMIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-28",
        "last_updated": "2012-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "008114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236338",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

Verify at the official NPI Registry.