Active NPI
Jill McCormick, LSW
- Clinical Social Worker
- Colorado Springs, CO
National Provider Identifier
1598263204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0009921426
- Practice address
- 3055 Austin Bluffs Pkwy
Colorado Springs, CO 80918-5748 - Phone
- (719) 344-9482
- NPI assigned
- Jan 28, 2018
- Last updated
- Jan 28, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 0009921426 | CO | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Griffith Centers, Inc. | Clinical | Past | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2018; 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.