Individual provider Active NPI

Jeremy A. Omerod, LCPC

  • Professional Counselor
  • Naperville, IL
National Provider Identifier
1457558561
Registry record updated Jun 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180006916 Issued in IL
Practice address
1819 Bay Scott Cir Ste 109
Naperville, IL 60540-1130
Phone
(630) 357-2456
NPI assigned
Jul 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180006916 IL Primary

Addresses

Primary practice location

1819 Bay Scott Cir Ste 109
Naperville, IL 60540-1130

Mailing address

431 South Ave
Aurora, IL 60505-4721
Phone (815) 508-2525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240501001423 IL Practitioner - Mental Health Counselor 0749620235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Interfaith Counseling Center IncGroup PAC ID 8426014994, 19 clinicians

Practice addresses (Care Compare)

1819 Bay Scott Cir
Suite 109
Naperville, IL 60540-1130
Phone (630) 357-2456

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Interfaith Counseling Center Inc. CurrentSince May 1, 2024 Accepting new patients
Samaritan Counseling Center PastSince May 1, 2024 Accepting new patients

Locations

1819 Bay Scott Cir
Ste 109
Naperville, IL 60540
Phone (630) 357-2456

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": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403740800000",
    "number": "1457558561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 SOUTH AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605054721",
            "telephone_number": "815-508-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 BAY SCOTT CIR STE 109",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605401130",
            "telephone_number": "630-357-2456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMEROD",
        "first_name": "JEREMY",
        "middle_name": "A.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-02",
        "last_updated": "2014-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180006916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.