Jackilyn Andrew, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7664 Issued in WI

Practice address

1400 Bellinger St
Eau Claire, WI 54703

Phone

(715) 838-5222

NPI assigned

Apr 16, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Clinical Social Worker

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mayo Clinic Health System-Northwest Wisconsin Region IncGroup PAC ID 4385553627, shared by 21 NPIs, 797 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mayo Clinic Health System Chippewa Valley Hospital, Bloomer, WI, CCN 521314

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Marshfield Clinic Inc

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981
  Medicare reassignment NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Multi-Specialty Clinic/Center
  • Eau Claire, WI
  • NPI 1235588831
  Medicare reassignment NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Critical Access Hospital
  • Bloomer, WI
  • NPI 1700837812
  Medicare reassignment NPD
• MCHS Hospitals Inc

  • Clinic/Center
  • Marshfield, WI
  • NPI 1093221434
  Medicare reassignment NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Rural Health Clinic/Center
  • Mondovi, WI
  • NPI 1174116669
  NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Multi-Specialty Clinic/Center
  • Barron, WI
  • NPI 1518494244
  NPD
• MCHS Hospitals Inc

  • Clinic/Center
  • Eau Claire, WI
  • NPI 1316416035
  NPD
• MCHS Hospitals Inc

  • Durable Medical Equipment & Medical Supplies
  • Eau Claire, WI
  • NPI 1558230847
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Critical Access Hospital
  • Bloomer, WI
  • NPI 1700837812
  Care Compare affiliation

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

{
    "created_epoch": "1271376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1588980403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "715-838-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BELLINGER ST",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "54703",
            "telephone_number": "715-838-5222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Starr Ave",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547031821",
            "country_code": "US",
            "telephone_number": "715-858-4300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Starr Ave",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547031821",
            "country_code": "US",
            "telephone_number": "715-858-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDREW",
        "first_name": "JACKILYN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-16",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005989",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jandrew600770@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1400 Bellinger St",
            "city": "Eau Claire",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shannon Anderson
• Sophie Susanna Anderson, BSW, CSW, LSW
• Stacy Michelle Anding, R.D.H.
• Evan J Andor
• Brandon Daniel Andrew, M.D.
• Cailen Andrews
• Carne Jane Andrews, APNP
• Kelly Ann Andrews, DNP, FNP-C
• Roger G Andrews, PA
• Jeffrey K Anlauf, PT

• Clinical Social Worker in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.