Individual provider Active NPI

Terry L Janzen, MSWQ

  • Social Worker
  • Raymore, MO
National Provider Identifier
1659357887
Registry record updated Feb 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
005574 Issued in MO
Practice address
407 Laurus St
Raymore, MO 64083-8585
Phone
(816) 318-4430
Fax
(816) 318-8865
NPI assigned
Dec 20, 2005
Last updated
Feb 14, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2011

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 005574 MO Primary

Addresses

Primary practice location

407 Laurus St
Raymore, MO 64083-8585

Mailing address

516 W Santa Fe St
Olathe, KS 66061-3270

Other identifiers 1

IdentifierTypeStateIssuer
498612001MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110401000481 KS Practitioner - Clinical Social Worker 8426232224 Practice locations: Olathe, KS; Topeka, KS
I20110531000482 MO Practitioner - Clinical Social Worker 8426232224 Practice locations: Raymore, MO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

405 S Clairborne Rd
Suite 4
Olathe, KS 66062-1774
Phone (913) 206-7568

5847 SW 29TH St
Topeka, KS 66614-2462
Phone (785) 273-7292

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1190KSMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Health, Inc Past Accepting new patients
Compass Health, Inc Past Accepting new patients

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": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297641600000",
    "number": "1659357887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 W SANTA FE ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660613270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 LAURUS ST",
            "city": "RAYMORE",
            "state": "MO",
            "postal_code": "640838585",
            "telephone_number": "816-318-4430",
            "fax_number": "816-318-8865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANZEN",
        "first_name": "TERRY",
        "middle_name": "L",
        "credential": "MSWQ",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2011-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "005574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "498612001",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raymore, MO

Sources for this page

Verify at the official NPI Registry.