Individual provider Active NPI

Jessica Ann Mosey

  • Social Worker
  • Marinette, WI
National Provider Identifier
1588950984
Registry record updated Aug 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6802086489 Issued in MI
Practice address
2500 Hall Ave
Marinette, WI 54143-1655
Phone
(715) 732-7760
NPI assigned
Jun 23, 2011
Last updated
Aug 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 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 6802086489 MI Primary

Addresses

Primary practice location

2500 Hall Ave
Marinette, WI 54143-1655

Mailing address

2500 Hall Ave
Marinette, WI 54143-1655
Phone (715) 732-7760

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
I20210331002689 WI Practitioner - Clinical Social Worker 4789091174 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6802086489MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Marinette CurrentSince Feb 17, 2021 Accepting new patients
County of Marinette CurrentSince Feb 17, 2021 Accepting new patients

Locations

2500 Hall Ave
Ste A
Marinette, WI 54143
Phone (715) 732-7760

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, 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": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1588950984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 HALL AVE",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541431655",
            "telephone_number": "715-732-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 HALL AVE",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541431655",
            "telephone_number": "715-732-7760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSEY",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802086489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marinette, WI

Sources for this page

Verify at the official NPI Registry.