Individual provider Active NPI

Jennifer Sue Pielak, MSW

  • Social Worker
  • Moline, IL
National Provider Identifier
1558848994
Registry record updated Jul 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
091146 Issued in IA
Practice address
2326 16TH St
Moline, IL 61265-4824
Phone
(309) 283-1304
NPI assigned
Jul 27, 2018
Last updated
Jul 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 091146 IA Primary

Addresses

Primary practice location

2326 16TH St
Moline, IL 61265-4824

Mailing address

2326 16TH St
Moline, IL 61265-4824
Phone (309) 283-1304

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
091146IAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1532649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532649600000",
    "number": "1558848994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2326 16TH ST",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612654824",
            "telephone_number": "309-283-1304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2326 16TH ST",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612654824",
            "telephone_number": "309-283-1304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIELAK",
        "first_name": "JENNIFER",
        "middle_name": "SUE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-27",
        "last_updated": "2018-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "091146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.