Individual provider Active NPI

Jamie J Chapin, MSW

  • Clinical Social Worker
  • Evergreen, CO
National Provider Identifier
1578095279
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34009446A Issued in IN
Practice address
34507 Squaw Pass Rd
Evergreen, CO 80439-9727
Phone
(720) 642-6880
NPI assigned
Mar 31, 2017
Last updated
Oct 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 28629 MN
Clinical Social Worker 1041C0700X 9708-123 WI
Clinical Social Worker 1041C0700X 34009446A IN Primary

Addresses

Primary practice location

34507 Squaw Pass Rd
Evergreen, CO 80439-9727

Mailing address

34507 Squaw Pass Rd
Evergreen, CO 80439-9727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, TN, CO, IN4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20220203001766 WI Practitioner - Clinical Social Worker 0941693592 Reassigns benefits to 1 organization
I20220915003650 TN Practitioner - Clinical Social Worker 0941693592 Reassigns benefits to 2 organizations
I20230413002165 CO Practitioner - Clinical Social Worker 0941693592 Reassigns benefits to 1 organization
I20250208000175 IN Practitioner - Clinical Social Worker 0941693592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
National Deaf TherapyGroup PAC ID 8921438946, 8 clinicians

Practice addresses (Care Compare)

Appleton, WI 54913
Phone (800) 475-0711

Boulder, CO 80302
Phone (800) 475-0711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110096TXMDSpeech-Language Pathologist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1578095279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34507 SQUAW PASS RD",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804399727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34507 SQUAW PASS RD",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804399727",
            "telephone_number": "720-642-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPIN",
        "first_name": "JAMIE",
        "middle_name": "J",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-31",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "28629",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9708-123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34009446A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen, CO

Sources for this page

Verify at the official NPI Registry.