Active NPI
Jazette Anderson
- Social Worker
- Madison, WI
National Provider Identifier
1538846381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 133051-121
- Practice address
- 2810 Crossroads Dr
Madison, WI 53718-7942 - Phone
- (312) 476-9064
- Fax
- (312) 900-8230
- NPI assigned
- Jul 3, 2023
- Last updated
- Jul 3, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 133051-121 | WI | Primary |
Addresses
Primary practice location
2810 Crossroads Dr
Madison, WI 53718-7942
Mailing address
PO Box 752123
Houston, TX 77275-2123
Phone (312) 476-9064
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 |
|---|---|---|---|
| 133051-121 | WI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688342400000",
"number": "1538846381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 752123",
"city": "HOUSTON",
"state": "TX",
"postal_code": "772752123",
"telephone_number": "312-476-9064",
"fax_number": "312-476-9064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2810 CROSSROADS DR",
"city": "MADISON",
"state": "WI",
"postal_code": "537187942",
"telephone_number": "312-476-9064",
"fax_number": "312-900-8230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "JAZETTE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-07-03",
"last_updated": "2023-07-03",
"certification_date": "2023-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WI",
"license": "133051-121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.