Individual provider Active NPI

Jennifer J. Hibbs, LCSW

  • Clinical Social Worker
  • Medford, OR
National Provider Identifier
1447286927
Registry record updated Apr 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1324 Issued in OR
Practice address
33 N Central Ave
Ste. #416
Medford, OR 97501-5900
Phone
(541) 773-3460
Fax
(541) 500-8160
NPI assigned
Jun 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1324 OR Primary

Addresses

Primary practice location

33 N Central Ave
Ste. #416
Medford, OR 97501-5900

Mailing address

33 N Central Ave
Ste. #416
Medford, OR 97501-5900
Phone (541) 773-3460

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

LicenseStateTypeSpecialty
1324ORMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430265600000",
    "number": "1447286927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 N CENTRAL AVE",
            "address_2": "STE. #416",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975015900",
            "telephone_number": "541-773-3460",
            "fax_number": "541-500-8160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 N CENTRAL AVE",
            "address_2": "STE. #416",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975015900",
            "telephone_number": "541-773-3460",
            "fax_number": "541-500-8160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIBBS",
        "first_name": "JENNIFER",
        "middle_name": "J.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2015-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "1324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.