Active NPI
Jill Marie White, LCSW
- Clinical Social Worker
- Sevierville, TN
National Provider Identifier
1356895940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 5079
- Practice address
- 502 Winfield Dunn Pkwy
Sevierville, TN 37876-5509 - Phone
- (865) 280-6526
- Fax
- (865) 908-8277
- NPI assigned
- Aug 11, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 5079 | TN | |
| Clinical Social Worker | 1041C0700X | 5079 | TN | Primary |
Addresses
Primary practice location
502 Winfield Dunn Pkwy
Sevierville, TN 37876-5509
Mailing address
502 Winfield Dunn Pkwy
Sevierville, TN 37876-5509
Phone (865) 280-6526
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q025593 | Medicaid | TN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5079 | TN | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620086400000",
"number": "1356895940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "502 WINFIELD DUNN PKWY",
"city": "SEVIERVILLE",
"state": "TN",
"postal_code": "378765509",
"telephone_number": "865-280-6526",
"fax_number": "865-908-8277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "502 WINFIELD DUNN PKWY",
"city": "SEVIERVILLE",
"state": "TN",
"postal_code": "378765509",
"telephone_number": "865-280-6526",
"fax_number": "865-908-8277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "JILL",
"middle_name": "MARIE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-11",
"last_updated": "2021-05-04",
"certification_date": "2021-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "TN",
"license": "5079",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TN",
"license": "5079",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q025593",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sevierville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.