Individual provider Active NPI

Jessica Angus, LISW-S

  • Social Worker
  • Columbus, OH
National Provider Identifier
1699480830
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I.1901741-SUPV Issued in OH
Practice address
2720 Airport Dr
Columbus, OH 43219-2219
Phone
(614) 388-7672
NPI assigned
Jan 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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 I.1901741-SUPV OH Primary

Addresses

Primary practice location

2720 Airport Dr
Columbus, OH 43219-2219

Mailing address

420 N James Rd
Columbus, OH 43219-1834
Phone (614) 388-7672

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL securerecords.sanford.html Chalmers P. Wylie Ambulatory Care Center

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
I.1901741-SUPVOHMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1699480830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 N JAMES RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432191834",
            "telephone_number": "614-388-7672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 AIRPORT DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432192219",
            "telephone_number": "614-388-7672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGUS",
        "first_name": "JESSICA",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.1901741-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "securerecords.sanford.html",
            "affiliation": "Y",
            "affiliationName": "Chalmers P. Wylie Ambulatory Care Center",
            "address_1": "420 N James Rd",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432191834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.