Active NPI
Kemoy Jodiann Wilson, MSW
- Social Worker
- Greenacres,, FL
National Provider Identifier
1386994713
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 6416 Melalueca LN
Greenacres,, FL 33463 - Phone
- (561) 649-0877
- NPI assigned
- Sep 13, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
6416 Melalueca LN
Greenacres,, FL 33463
Mailing address
12123 W Sample Rd
Coral Springs, FL 33065
Phone (954) 990-9427
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347494400000",
"number": "1386994713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12123 W SAMPLE RD",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "33065",
"telephone_number": "954-990-9427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6416 MELALUECA LN",
"city": "GREENACRES,",
"state": "FL",
"postal_code": "33463",
"telephone_number": "561-649-0877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "KEMOY",
"middle_name": "JODIANN",
"name_prefix": "Mrs.",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-13",
"last_updated": "2012-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenacres,, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.