Active NPI
Nicole Lynn Jasso
- Clinical Social Worker
- Joplin, MO
National Provider Identifier
1649838780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2022028662
- Practice address
- 3010 McClelland
Joplin, MO 64804 - Phone
- (417) 347-7700
- NPI assigned
- Jun 4, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2020012454 | MO | |
| Case Manager/Care Coordinator | 171M00000X | |||
| Clinical Social Worker | 1041C0700X | 2022028662 | MO | Primary |
Addresses
Primary practice location
3010 McClelland
Joplin, MO 64804
Mailing address
PO Box 2526
Joplin, MO 64803-2526
Phone (417) 347-7579
Other names 1
- Nicole Lynn Egan
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020012454 | MO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659312000000",
"number": "1649838780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2526",
"city": "JOPLIN",
"state": "MO",
"postal_code": "648032526",
"telephone_number": "417-347-7579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3010 MCCLELLAND",
"city": "JOPLIN",
"state": "MO",
"postal_code": "64804",
"telephone_number": "417-347-7700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JASSO",
"first_name": "NICOLE",
"middle_name": "LYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-04",
"last_updated": "2022-08-01",
"certification_date": "2022-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "2020012454",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "2022028662",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "NICOLE",
"last_name": "EGAN",
"middle_name": "LYNN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Joplin, MO
- Jasper County Sheltered Facilities Assoc
- Jasper County Sheltered Facilities Assoc
- Jasper County Sheltered Facilities Board
- Jasper County Sheltered Facilities Board
- Erika Yissel Jasso, MD
- Maheen Jawaid, MD
- Nicholas Lowell Jaworski
- Jay Hatfield Mobility, LLC
- Jay Rehabilitation Services LLC
- Yaso M Jayawardhana, NP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.