Individual provider Active NPI

Jeff Parker, LMSW

  • Clinical Social Worker
  • Malvern, AR
National Provider Identifier
1528536729
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10147C Issued in AR
Practice address
829 Halbert St
Malvern, AR 72104-2607
Phone
(501) 332-4400
Fax
(501) 332-4403
NPI assigned
Nov 6, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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 10147C AR Primary

Addresses

Primary practice location

829 Halbert St
Malvern, AR 72104-2607

Mailing address

829 Halbert St
Malvern, AR 72104-2607
Phone (501) 332-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20230809002871 AR Practitioner - Clinical Social Worker 2567824493 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10147CARMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
TFS of Gurdon Inc CurrentSince Jul 14, 2023 Accepting new patients
Waypoint Mental Health Inc Clinical Current Accepting new patients

Locations

829 Halbert St
Malvern, AR 72104
Phone (501) 332-4400

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.

NPI Registry JSON

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

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1528536729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 HALBERT ST",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721042607",
            "telephone_number": "501-332-4400",
            "fax_number": "501-332-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 HALBERT ST",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721042607",
            "telephone_number": "501-332-4400",
            "fax_number": "501-332-4403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "JEFF",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-06",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "10147C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malvern, AR

Sources for this page

Verify at the official NPI Registry.