Individual provider Active NPI

Alex James

  • Clinical Social Worker
  • Jefferson, WI
National Provider Identifier
1588218994
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1541 Annex Rd
Jefferson, WI 53549-9803
Phone
(920) 674-8162
NPI assigned
Jul 25, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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 Primary

Addresses

Primary practice location

1541 Annex Rd
Jefferson, WI 53549-9803

Mailing address

1541 Annex Rd
Jefferson, WI 53549-9803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20210202001035 WI Practitioner - Clinical Social Worker 6305250424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson CountyGroup PAC ID 2264496801, 19 clinicians

Practice addresses (Care Compare)

1541 Annex Rd
Jefferson, WI 53549-9803
Phone (920) 674-3105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson County CurrentSince Jan 13, 2021 Accepting new patients
Jefferson County CurrentSince Jan 13, 2021 Accepting new patients

Locations

1541 Annex Rd
Jefferson, WI 53549
Phone (920) 674-3105

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": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1588218994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 ANNEX RD",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535499803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 ANNEX RD",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535499803",
            "telephone_number": "920-674-8162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES",
        "first_name": "ALEX",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-25",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, WI

Sources for this page

Verify at the official NPI Registry.