Active NPI
Jillian R Luttrell
- Clinical Social Worker
- Lafayette, IN
National Provider Identifier
1518440924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34008071A
- Practice address
- 1716 Hartford St
Lafayette, IN 47904-2138 - Phone
- (765) 742-1567
- NPI assigned
- Sep 11, 2018
- Sex
- Female
- 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 | 34008071A | IN | Primary |
Addresses
Primary practice location
1716 Hartford St
Lafayette, IN 47904-2138
Mailing address
1716 Hartford St
Lafayette, IN 47904-2138
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brightside Health, Inc. | Current | Accepting new patients | |
| Riggs Community Health Center Inc | Past | Accepting new patients |
Locations
2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615
17 N 5th Ave
#1021
Beech Grove, IN 46107
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.
-
- Federally Qualified Health Center (FQHC)
- Lafayette, IN
- NPI 1386876233
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536624000000",
"number": "1518440924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1716 HARTFORD ST",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479042138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1716 HARTFORD ST",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479042138",
"telephone_number": "765-742-1567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUTTRELL",
"first_name": "JILLIAN",
"middle_name": "R",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-11",
"last_updated": "2018-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34008071A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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- James E. Lutz, D.D.S.
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- Luxottica Retail North America Inc (Sears Optical #C0505)
- Bethany Ann Lyon, DO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.