Individual provider Active NPI

Jodi Brooke Neumann

  • Clinical Social Worker
  • Traverse City, MI
National Provider Identifier
1346444643
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801093452 Issued in MI
Practice address
1050 Silver Dr
Traverse City, MI 49684-5749
Phone
(231) 947-2255
NPI assigned
Jun 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

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 6801093452 MI Primary

Addresses

Primary practice location

1050 Silver Dr
Traverse City, MI 49684-5749

Mailing address

1315 W Harvest
Traverse City, MI 49685-8626
Phone (231) 313-9165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20111104000526 MI Practitioner - Clinical Social Worker 0143493296 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1200 W Eleventh St
Suite 114
Traverse City, MI 49684-3288
Phone (231) 493-2111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Rest Christian Mental Health Services CurrentSince Sep 20, 2011 Accepting new patients
Courageous Life Counseling CurrentSince Mar 5, 2018 Accepting new patients
Pine Rest Christian Mental Health Services Social Worker CurrentSince Sep 20, 2011 Accepting new patients

Locations

1200 W Eleventh St
Ste 114
Traverse City, MI 49684
Phone (231) 493-2111

300 68th St SE
Wyoming, MI 49548
Phone (616) 455-5000

Organizations & group practices 3

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": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1346444643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 W HARVEST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496858626",
            "telephone_number": "231-313-9165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 SILVER DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496845749",
            "telephone_number": "231-947-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUMANN",
        "first_name": "JODI",
        "middle_name": "BROOKE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801093452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.