Angela Gregory Jackson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2010014901 Issued in MO

Practice address

5701 NW 64TH Ter
Kansas City, MO 64151-2382

Phone

(816) 319-0632

NPI assigned

Nov 17, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Angela Mary Gregory Former name

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Clinical Social Worker

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1226880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1508010604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7305 NW 76TH PL",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641522283",
            "telephone_number": "816-803-9132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 NW 64TH TER",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641512382",
            "telephone_number": "816-319-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANGELA",
        "middle_name": "GREGORY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-17",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2010014901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "GREGORY",
            "middle_name": "MARY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jackson County, Missouri
• Jackson Family Dental LLC
• Jackson Style Group Home
• Teklyn Sarahn Jackson-Davis, MS, SLP-CCC
• Jennifer J Jackson-Rice, LCSW
• Aniika Richann Jackson, DDS
• Anthony Earle Jackson
• Brandi L Jackson, DPT
• Breaunnah Bloomer Jackson, MD
• Casey Eden Jackson, PLPC

• Clinical Social Worker in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.