Individual provider Active NPI

Jennifer Hernandez, LCSW

  • Clinical Social Worker
  • Osage Beach, MO
National Provider Identifier
1508213190
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2023045063 Issued in MO
Practice address
980 Parkside Village LN
Osage Beach, MO 65065-3098
Phone
(844) 853-8937
NPI assigned
May 24, 2016
Last updated
Jul 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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 2023045063 MO Primary

Addresses

Primary practice location

980 Parkside Village LN
Osage Beach, MO 65065-3098

Mailing address

1800 Community
Clinton, MO 64735-8804
Phone (660) 885-8131

Other practice location 1

63 Vfw Rd
Camdenton, MO 65020-8411
Phone (844) 853-8937

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240627001302 MO Practitioner - Clinical Social Worker 6901340272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Compass Health IncGroup PAC ID 1951206754, 317 clinicians

Practice addresses (Care Compare)

980 Parkside Village LN
Osage Beach, MO 65065-3098
Phone (888) 403-1071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023045063MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Health, Inc Clinical CurrentSince Jun 24, 2024 Accepting new patients
Compass Health, Inc CurrentSince Jun 24, 2024 Accepting new patients

Locations

63 Vfw Rd
Camdenton, MO 65020

1800 Community
Clinton, MO 64735
Phone (660) 885-8131

1800 Community
#B
Clinton, MO 64735

980 Parkside Village Ln
Osage Beach, MO 65065
Phone (573) 302-1114

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1508213190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "660-885-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 PARKSIDE VILLAGE LN",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653098",
            "telephone_number": "844-853-8937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "63 Vfw Rd",
            "address_purpose": "LOCATION",
            "city": "Camdenton",
            "state": "MO",
            "postal_code": "650208411",
            "country_code": "US",
            "telephone_number": "844-853-8937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-24",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2023045063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Osage Beach, MO

Sources for this page

Verify at the official NPI Registry.