Individual provider Active NPI

Jolene Carol Atkinson, MSW

  • Clinical Social Worker
  • Davenport, IA
National Provider Identifier
1326093725
Registry record updated Dec 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
00975 Issued in IA
Practice address
2102 E 38TH St
Davenport, IA 52807-1135
Phone
(563) 359-4049
Fax
(563) 359-4069
NPI assigned
May 23, 2006
Last updated
Dec 18, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2017

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 00975 IA Primary

Addresses

Primary practice location

2102 E 38TH St
Davenport, IA 52807-1135

Mailing address

2102 E 38TH St
Davenport, IA 52807-1135
Phone (563) 359-4049

Other names 1

  • Jolene Carol Atkinson-Kruse Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20050926000430 IA Practitioner - Clinical Social Worker 7214961549 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychology Health GroupGroup PAC ID 7810887452, 10 clinicians

Practice addresses (Care Compare)

2102 E 38TH St
Davenport, IA 52807-1135
Phone (563) 359-4049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, 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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513555200000",
    "number": "1326093725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2102 E 38TH ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071135",
            "telephone_number": "563-359-4049",
            "fax_number": "563-359-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 E 38TH ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071135",
            "telephone_number": "563-359-4049",
            "fax_number": "563-359-4069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATKINSON",
        "first_name": "JOLENE",
        "middle_name": "CAROL",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2017-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "00975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOLENE",
            "last_name": "ATKINSON-KRUSE",
            "middle_name": "CAROL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.