Individual provider Active NPI

Jill McCormick, LSW

  • Clinical Social Worker
  • Colorado Springs, CO
National Provider Identifier
1598263204
Registry record updated Jan 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0009921426 Issued in CO
Practice address
3055 Austin Bluffs Pkwy
Colorado Springs, CO 80918-5748
Phone
(719) 344-9482
NPI assigned
Jan 28, 2018
Last updated
Jan 28, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2018

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 0009921426 CO Primary

Addresses

Primary practice location

3055 Austin Bluffs Pkwy
Colorado Springs, CO 80918-5748

Mailing address

1609 N Nevada Ave
Colorado Springs, CO 80907-7434
Phone (719) 640-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20210211001297 CO Practitioner - Clinical Social Worker 1456766120 Practice locations: Colorado Springs, CO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1609 N Nevada Ave
Colorado Springs, CO 80907-7434
Phone (719) 640-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0009921426COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Griffith Centers, Inc. Clinical PastSince Oct 1, 2019 Accepting new patients

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": "1517097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517097600000",
    "number": "1598263204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 N NEVADA AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809077434",
            "telephone_number": "719-640-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3055 AUSTIN BLUFFS PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809185748",
            "telephone_number": "719-344-9482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "JILL",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-28",
        "last_updated": "2018-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "0009921426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.