Individual provider Active NPI

Jane Moore, LCSW

  • Clinical Social Worker
  • Centennial, CO
National Provider Identifier
1639239700
Registry record updated Dec 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
992032 Issued in CO
Practice address
7030 S Yosemite St
Centennial, CO 80112-2026
Phone
(303) 721-9984
NPI assigned
Dec 11, 2006
Last updated
Dec 5, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2016

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 992032 CO Primary

Addresses

Primary practice location

7030 S Yosemite St
Centennial, CO 80112-2026

Mailing address

7030 S Yosemite St
Centennial, CO 80112-2026
Phone (303) 721-9984

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
I20170220001322 CO Practitioner - Clinical Social Worker 8123301074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinix Health Services of Colorado IncGroup PAC ID 1759277056, 8 clinicians

Practice addresses (Care Compare)

7030 S Yosemite St
Suite 210
Centennial, CO 80112-2025
Phone (303) 721-9984

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
992032COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Clinix Health Services of Colorado Inc CurrentSince Dec 5, 2016 Accepting new patients
Clinix Health Services Past Accepting new patients

Locations

7030 S Yosemite St
Centennial, CO 80112
Phone (303) 721-9984

7030 S Yosemite St
#210
Centennial, CO 80112

7030 S Yosemite St
Ste 210
Centennial, CO 80112
Phone (303) 721-9984

7030 S Yosemite St
Ste 220
Centennial, CO 80112
Phone (303) 721-9984

Organizations & group practices 2

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1639239700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7030 S YOSEMITE ST",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801122026",
            "telephone_number": "303-721-9984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7030 S YOSEMITE ST",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801122026",
            "telephone_number": "303-721-9984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JANE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "992032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

Verify at the official NPI Registry.