Individual provider Active NPI

Abigail L Bloomquist, LMSW

  • Clinical Social Worker
  • Jamestown, NY
National Provider Identifier
1306112420
Registry record updated Mar 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
085869 Issued in NY
Practice address
200 Dunham Ave
Jamestown, NY 14701-2528
Phone
(716) 661-1583
NPI assigned
Mar 23, 2012
Last updated
Mar 23, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 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 085869 NY Primary

Addresses

Primary practice location

200 Dunham Ave
Jamestown, NY 14701-2528

Mailing address

344 E 4TH St
Jamestown, NY 14701-5502
Phone (716) 661-1590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20171003005725 NY Practitioner - Clinical Social Worker 7719252626 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085869NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Chautauqua County Chapter of Nysarc Inc CurrentSince Aug 1, 2017 Accepting new patients
Chautauqua County Chapter of Nysarc Inc CurrentSince Aug 1, 2017 Accepting new patients
Chautauqua Co. Chapter of Nysarc Inc Dba the Resource Center Current Accepting new patients
The Resource Center Past Accepting new patients

Locations

200 Dunham Ave
Jamestown, NY 14701
Phone (716) 661-1400

880 E 2nd St
Jamestown, NY 14701
Phone (716) 661-1400

890 E 2nd St
Jamestown, NY 14701
Phone (716) 661-1447

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1332460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332460800000",
    "number": "1306112420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 E 4TH ST",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147015502",
            "telephone_number": "716-661-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DUNHAM AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147012528",
            "telephone_number": "716-661-1583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOMQUIST",
        "first_name": "ABIGAIL",
        "middle_name": "L",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-23",
        "last_updated": "2012-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "085869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NY

Sources for this page

Verify at the official NPI Registry.