Individual provider Active NPI

Jane Elizabeth Chippendale

  • Social Worker
  • Encinitas, CA
National Provider Identifier
1366001059
Registry record updated Jun 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1252 Berryman Cyn
Encinitas, CA 92024-7915
Phone
(760) 518-5303
NPI assigned
Jun 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2019

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 Primary

Addresses

Primary practice location

1252 Berryman Cyn
Encinitas, CA 92024-7915

Mailing address

1252 Berryman Cyn
Encinitas, CA 92024-7915
Phone (760) 518-5303

Other identifiers 1

IdentifierTypeStateIssuer
91082200G08130MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Care of Pennsylvania LLC CurrentSince Nov 9, 2024 Accepting new patients

Locations

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

2109 Red Lion Rd
Philadelphia, PA 19115
Phone (215) 213-7000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559779200000",
    "number": "1366001059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1252 BERRYMAN CYN",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920247915",
            "telephone_number": "760-518-5303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1252 BERRYMAN CYN",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920247915",
            "telephone_number": "760-518-5303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIPPENDALE",
        "first_name": "JANE",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-06",
        "last_updated": "2019-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "91082200G08130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

Verify at the official NPI Registry.