Individual provider Active NPI

Jamika White

  • Social Worker
  • Glen Burnie, MD
National Provider Identifier
1639788904
Registry record updated Jul 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1478 Braden Loop
Glen Burnie, MD 21061-5017
Phone
(443) 569-9093
NPI assigned
Jul 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

1478 Braden Loop
Glen Burnie, MD 21061-5017

Mailing address

1478 Braden Loop
Glen Burnie, MD 21061-5017
Phone (443) 569-9093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20210405000892 MD Practitioner - Clinical Social Worker 6800203100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ags Programs LLCGroup PAC ID 7416364484, 5 clinicians

Practice addresses (Care Compare)

1212 N Wolfe St
Baltimore, MD 21213-3303
Phone (410) 276-2123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18519MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ags Programs LLC CurrentSince Mar 3, 2021 Accepting new patients

Locations

1212 N Wolfe St
Baltimore, MD 21213
Phone (410) 276-2123

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1639788904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1478 BRADEN LOOP",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615017",
            "telephone_number": "443-569-9093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1478 BRADEN LOOP",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615017",
            "telephone_number": "443-569-9093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JAMIKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.