Individual provider Active NPI

Darrell Jamison

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1477024883
Registry record updated Dec 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
19194 Issued in MD
Practice address
2519 Maryland Ave Ste 100
Baltimore, MD 21218-4995
Phone
(443) 765-1458
NPI assigned
Dec 10, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2018

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 19194 MD Primary

Addresses

Primary practice location

2519 Maryland Ave Ste 100
Baltimore, MD 21218-4995

Mailing address

2519 Maryland Ave Ste 100
Baltimore, MD 21218-4995
Phone (443) 765-1458

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20200511000037 MD Practitioner - Clinical Social Worker 3870924798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrative Behavioral Health,LLCGroup PAC ID 2961833884, 4 clinicians

Practice addresses (Care Compare)

2519 Maryland Ave
Suite 100
Baltimore, MD 21218-4995
Phone (443) 765-1458

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Behavioral Health,LLC Clinical CurrentSince Apr 22, 2020 Accepting new patients
Integrative Behavioral Health,LLC Past Accepting new patients
Integrative Behavioral Health,LLC Past Accepting new patients

Locations

2519 Maryland Ave
Ste 100
Baltimore, MD 21218
Phone (443) 288-0098

Organizations & group practices 3

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": "1544400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1477024883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2519 MARYLAND AVE STE 100",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212184995",
            "telephone_number": "443-765-1458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2519 MARYLAND AVE STE 100",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212184995",
            "telephone_number": "443-765-1458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMISON",
        "first_name": "DARRELL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-10",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "19194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.