Active NPI
Jason Wead
- Clinical Social Worker
- Springfield, MO
National Provider Identifier
1508427063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2012021500
- Practice address
- 5264 S Timberlake Dr
Springfield, MO 65804-7723 - Phone
- (484) 429-3540
- NPI assigned
- Jun 25, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2012021500 | MO | Primary |
Addresses
Primary practice location
5264 S Timberlake Dr
Springfield, MO 65804-7723
Mailing address
5264 S Timberlake Dr
Springfield, MO 65804-7723
Phone (484) 429-3540
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2012021500 | MO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561420800000",
"number": "1508427063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5264 S TIMBERLAKE DR",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658047723",
"telephone_number": "484-429-3540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5264 S TIMBERLAKE DR",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658047723",
"telephone_number": "484-429-3540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEAD",
"first_name": "JASON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-25",
"last_updated": "2019-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "2012021500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.