Individual provider Active NPI

Jennifer Martin

  • Clinical Social Worker
  • Quincy, IL
National Provider Identifier
1336697010
Registry record updated Sep 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149018759 Issued in IL
Practice address
4409 Maine St
Quincy, IL 62305-5849
Phone
(217) 223-0423
Fax
(217) 223-0461
NPI assigned
Sep 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2016

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 149018759 IL Primary

Addresses

Primary practice location

4409 Maine St
Quincy, IL 62305-5849

Mailing address

4409 Maine St
Quincy, IL 62305-5849
Phone (217) 223-0423

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180815001219 IL Practitioner - Clinical Social Worker 8325397938 Reassigns benefits to 3 organizations
I20180918004171 MO Practitioner - Clinical Social Worker 8325397938 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blessing HospitalGroup PAC ID 3072422534, 414 clinicians

Practice addresses (Care Compare)

6996 County Rd
Suite 326
Palmyra, MO 63461-3119
Phone (217) 223-8400

927 Broadway St
Quincy, IL 62301-2719
Phone (217) 224-6423

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149018759ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Quincy Clinical Laboratory Services SC Current Accepting new patients
Blessingcare Corporation CurrentSince Jun 30, 2018 Accepting new patients
Blessing Corporate Services, Inc Current Accepting new patients
Blessing Hospital CurrentSince May 14, 2023 Accepting new patients
Blessing Hospital CurrentSince May 14, 2023 Accepting new patients
Blessingcare Corporation CurrentSince Jun 30, 2018 Accepting new patients
West Central Pathology Specialists, S.C. Current Accepting new patients
Blessingcare Corporation CurrentSince Jun 30, 2018 Accepting new patients

Locations

640 W Washington St
Pittsfield, IL 62363
Phone (217) 285-2113

1005 Broadway St
Quincy, IL 62301

927 Broadway St
Ste 121
Quincy, IL 62301

1102 N County Road 700
Warsaw, IL 62379
Phone (217) 256-3800

101 Medical Dr
Hannibal, MO 63401

103 E Commercial St
Kahoka, MO 63445
Phone (660) 727-3377

6996 County Road 326
Palmyra, MO 63461
Phone (573) 769-3710

Interoperability endpoints

  • FHIR API: https://fhir.blessinghospital.com/R4/open-Prod

Organizations & group practices 8

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": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1336697010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4409 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623055849",
            "telephone_number": "217-223-0423",
            "fax_number": "217-223-0461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4409 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623055849",
            "telephone_number": "217-223-0423",
            "fax_number": "217-223-0461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-12",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149018759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.