Individual provider Active NPI

Jayan Eder Thomas, LCSW

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1609989151
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3122 Issued in KY
Practice address
13804 Lake Point Cir Ste 101
Louisville, KY 40223-4239
Phone
(502) 805-5858
Fax
(502) 805-5859
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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 3122 KY Primary

Addresses

Primary practice location

13804 Lake Point Cir Ste 101
Louisville, KY 40223-4239

Mailing address

13804 Lake Point Cir Ste 101
Louisville, KY 40223-4239
Phone (502) 805-5858

Other identifiers 4

IdentifierTypeStateIssuer
000000712560OtherKYANTHEM - NNS
000057119DOtherKYHUMANA - NNS
124684OtherKYSIHO - NNS
2278675OtherKYCIGNA - NNS

Other names 1

  • Jayan Sue Eder Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20110413000825 KY Practitioner - Clinical Social Worker 3678757705 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Chronic Illness Counseling Center LLCGroup PAC ID 3274930896, 10 clinicians

Practice addresses (Care Compare)

13804 Lake Point Cir
Suite 101
Louisville, KY 40223-4239
Phone (502) 805-5858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Clinical CurrentSince Mar 10, 2011 Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
Chronic Illness Counseling Center LLC Clinical CurrentSince Jun 16, 2021 Accepting new patients
Community Medical Associates, Inc. CurrentSince Mar 10, 2011 Accepting new patients

Locations

13804 Lake Point Cir
Ste 101
Louisville, KY 40223
Phone (502) 245-7258

914 Lily Creek Rd
Ste 102
Louisville, KY 40243
Phone (502) 592-3583

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

3991 Dutchmans Ln
Ste 300
Louisville, KY 40207
Phone (502) 559-1970

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1609989151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13804 LAKE POINT CIR STE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402234239",
            "telephone_number": "502-805-5858",
            "fax_number": "502-805-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13804 LAKE POINT CIR STE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402234239",
            "telephone_number": "502-805-5858",
            "fax_number": "502-805-5859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JAYAN",
        "middle_name": "EDER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "3122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM - NNS",
            "identifier": "000000712560",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA - NNS",
            "identifier": "000057119D",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO - NNS",
            "identifier": "124684",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA - NNS",
            "identifier": "2278675",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAYAN",
            "last_name": "EDER",
            "middle_name": "SUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.