Individual provider Active NPI

Jackson Cole Schumacher, LCSW, MSW

  • Clinical Social Worker
  • Pierre, SD
National Provider Identifier
1316550601
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4996 Issued in SD
Practice address
2001 Eastgate Ave.
Pierre, SD 57501-5691
Phone
(605) 224-5811
Fax
(605) 224-6921
NPI assigned
Aug 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

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 4996 SD Primary

Addresses

Primary practice location

2001 Eastgate Ave.
Pierre, SD 57501-5691

Mailing address

2001 Eastgate Ave.
Pierre, SD 57501-5691
Phone (605) 224-5811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20220921000371 SD Practitioner - Clinical Social Worker 1254715444 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4996SDMDPulmonary Disease Physician

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": "1598400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1316550601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 EASTGATE AVE.",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575015691",
            "telephone_number": "605-224-5811",
            "fax_number": "605-224-6921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 EASTGATE AVE.",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575015691",
            "telephone_number": "605-224-5811",
            "fax_number": "605-224-6921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUMACHER",
        "first_name": "JACKSON",
        "middle_name": "COLE",
        "name_prefix": "Mr.",
        "credential": "LCSW, MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-26",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SD",
            "license": "4996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pierre, SD

Sources for this page

Verify at the official NPI Registry.