Individual provider Active NPI

Jillian M Viessman

  • Social Worker
  • Watertown, SD
National Provider Identifier
1366836264
Registry record updated Mar 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LCSW2958 Issued in SD
Practice address
1424 9TH Ave SE Ste 7
Watertown, SD 57201-5361
Phone
(605) 882-2740
NPI assigned
Mar 28, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2015

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 LCSW2958 SD Primary

Addresses

Primary practice location

1424 9TH Ave SE Ste 7
Watertown, SD 57201-5361

Mailing address

705 E 41St St Ste 200
Sioux Falls, SD 57105-6048
Phone (605) 444-7512

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1427500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427500800000",
    "number": "1366836264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 E 41ST ST STE 200",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571056048",
            "telephone_number": "605-444-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 9TH AVE SE STE 7",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572015361",
            "telephone_number": "605-882-2740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIESSMAN",
        "first_name": "JILLIAN",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-28",
        "last_updated": "2015-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SD",
            "license": "LCSW2958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2015; 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.