Individual provider Active NPI

Jennessa Hart, MSW

  • Clinical Social Worker
  • Panama City Beach, FL
National Provider Identifier
1275901035
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
7402 McElvey Rd
Panama City Beach, FL 32408-7606
Phone
(850) 249-0433
NPI assigned
Sep 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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 Primary

Addresses

Primary practice location

7402 McElvey Rd
Panama City Beach, FL 32408-7606

Mailing address

2121 Lisenby Ave
Panama City, FL 32405-2910
Phone (850) 763-7102

Other identifiers 1

IdentifierTypeStateIssuer
075436605MedicaidFL

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anchorage Children'S Home of Bay County, Inc Past Accepting new patients

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": "1441843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441843200000",
    "number": "1275901035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 LISENBY AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324052910",
            "telephone_number": "850-763-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7402 MCELVEY RD",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324087606",
            "telephone_number": "850-249-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "JENNESSA",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-10",
        "last_updated": "2015-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "075436605",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; 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.