Individual provider Active NPI

Jamie Daling

  • Clinical Social Worker
  • Fort Wayne, IN
National Provider Identifier
1528582178
Registry record updated Jul 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34007888A Issued in IN
Practice address
5800 Fairfield Ave
Fort Wayne, IN 46807-3400
Phone
(260) 745-9431
NPI assigned
Jul 26, 2017
Last updated
Jul 26, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2017

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 34007888A IN Primary

Addresses

Primary practice location

5800 Fairfield Ave
Fort Wayne, IN 46807-3400

Mailing address

2423 Fairfield Ave
Fort Wayne, IN 46807-1210
Phone (260) 745-9431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1501027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501027200000",
    "number": "1528582178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 FAIRFIELD AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468071210",
            "telephone_number": "260-745-9431",
            "fax_number": "260-745-0734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 FAIRFIELD AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468073400",
            "telephone_number": "260-745-9431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALING",
        "first_name": "JAMIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-26",
        "last_updated": "2017-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007888A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.