Jessica Keitz, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

09924779 Issued in CO

Practice address

1327 Bayfield Pkwy
Suite a
Bayfield, CO 81122

Phone

(970) 759-6891

NPI assigned

Apr 1, 2019

Last updated

Apr 1, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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, 2010

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ozark Tri-County Health Care Consortium

  dba Access Family Care

  • Federally Qualified Health Center (FQHC)
  • Anderson, MO
  • NPI 1265428791
  Medicare reassignment NPD
• Ozark Tri-County Health Care Consortium

  dba Access Family Care

  • Federally Qualified Health Center (FQHC)
  • Joplin, MO
  • NPI 1649837444
  NPD

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1609338623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13145 COUNTY ROAD 502",
            "city": "BAYFIELD",
            "state": "CO",
            "postal_code": "811229014",
            "telephone_number": "970-759-6891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 BAYFIELD PKWY",
            "address_2": "SUITE A",
            "city": "BAYFIELD",
            "state": "CO",
            "postal_code": "81122",
            "telephone_number": "970-759-6891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITZ",
        "first_name": "JESSICA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "09924779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jay E. Highland, OD
• Elisa Jaymes Horrocks, LPC
• Integrative Wellness Therapy
• Lisa Isenberg, MSN PNP
• Joshua Ryan Jimenez
• Tony Patrick Kimball, DC
• Preston R Knight, D.D.S.
• La Plata County School District 10 JT-R
• Lake Chiropractic, PC
• Andrew Edgar Lake, D.C.

• Clinical Social Worker in Bayfield, CO
• Providers in Bayfield, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; 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.