Individual provider Active NPI

Jeremy Deger, LISW-S

  • Clinical Social Worker
  • Youngstown, OH
National Provider Identifier
1316492853
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1901686 Issued in OH
Practice address
2031 Belmont Ave
Youngstown, OH 44505-2401
Phone
(330) 480-2840
Fax
(330) 480-2851
NPI assigned
Aug 24, 2016
Last updated
May 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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 I.1901686 OH Primary

Addresses

Primary practice location

2031 Belmont Ave
Youngstown, OH 44505-2401

Mailing address

725 E Market St
Akron, OH 44305-2421
Phone (330) 315-2639

Other identifiers 1

IdentifierTypeStateIssuer
0262247MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20190816002193 OH Practitioner - Clinical Social Worker 8022345818 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1044 Belmont Ave
Youngstown, OH 44504-1006
Phone (330) 480-3655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince May 30, 2024 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince May 30, 2024 Accepting new patients
Community Drug Board, Inc Current Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC Current Accepting new patients
Community Drug Board, Inc CurrentSince Jul 11, 2019 Accepting new patients
Community Drug Board, Inc CurrentSince Jul 11, 2019 Accepting new patients
Community Drug Board, Inc Current Accepting new patients

Locations

725 E Market St
Akron, OH 44305
Phone (330) 434-4141

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

2031 Belmont Ave
Youngstown, OH 44505
Phone (330) 480-3605

Organizations & group practices 7

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": "1471996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1316492853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 E MARKET ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443052421",
            "telephone_number": "330-315-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2031 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445052401",
            "telephone_number": "330-480-2840",
            "fax_number": "330-480-2851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGER",
        "first_name": "JEREMY",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-24",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1901686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0262247",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.