Individual provider Active NPI

Christina Marie Rust Seim, MSW

  • Clinical Social Worker
  • Jacksonville, FL
National Provider Identifier
1417308487
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
555 Stockton St
Jacksonville, FL 32204-2534
Phone
(904) 387-4661
NPI assigned
Jun 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X SW15754 FL
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

555 Stockton St
Jacksonville, FL 32204-2534

Mailing address

555 Stockton St
Jacksonville, FL 32204-2534
Phone (904) 387-4661

Other practice location 1

4595 Lexington Ave
Jacksonville, FL 32210-2058
Phone (404) 448-4700 ext. 524

Other names 1

  • Christina Marie Rust Former name

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
Gateway Community Services, Inc. CurrentSince Jan 19, 2023 Accepting new patients
Gateway Community Services, Inc. PastSince Jan 17, 2022 Accepting new patients

Locations

920 Bridier St
Jacksonville, FL 32206
Phone (904) 387-4661

2133 Broadway Ave
Jacksonville, FL 32209
Phone (904) 361-5010

940 Bridier St
Jacksonville, FL 32206

555 Stockton St
Jacksonville, FL 32204
Phone (904) 387-4661

Organizations & group practices 2

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": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1417308487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 STOCKTON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322042534",
            "telephone_number": "904-387-4661",
            "fax_number": "904-389-8578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 STOCKTON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322042534",
            "telephone_number": "904-387-4661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4595 Lexington Ave",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322102058",
            "country_code": "US",
            "telephone_number": "404-448-4700 x524",
            "fax_number": "904-783-1901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEIM",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE RUST",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW15754",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "RUST",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.