Individual provider Active NPI

Jeramie Anderson

  • Social Worker
  • Rock Island, IL
National Provider Identifier
1336032408
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
131651 Issued in IA
Practice address
2200 3Rd Ave
Rock Island, IL 61201-8840
Phone
(309) 779-2094
NPI assigned
May 29, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 131651 IA Primary

Addresses

Primary practice location

2200 3Rd Ave
Rock Island, IL 61201-8840

Mailing address

2911 6TH Ave
Rock Island, IL 61201-1914
Phone (563) 506-0513

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

State licenses

LicenseStateTypeSpecialty
131651IAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1748476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1336032408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 6TH AVE",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612011914",
            "telephone_number": "563-506-0513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 3RD AVE",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612018840",
            "telephone_number": "309-779-2094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JERAMIE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-29",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "131651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Island, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; 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.