Randi Ellen Jeddis, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SC01726 Issued in NJ

Practice address

349 Passaic Ave
Nutley, NJ 07110-2738

Phone

(973) 214-5988

NPI assigned

Jul 6, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Clinical Social Worker

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Randi E. Jeddis, MSW,LCSW,LLC

  • Social Worker
  • Cedar Grove, NJ
  • NPI 1568636504
  NPD (past) Authorized official

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1699973040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 PASSAIC AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071102738",
            "telephone_number": "973-214-5988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 PASSAIC AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071102738",
            "telephone_number": "973-214-5988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEDDIS",
        "first_name": "RANDI",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-06",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "SC01726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank D Jacob, LSW
• James and Annette Franklin MD
• James V Agresti DO LLC
• Janette Nutley Center
• Ana E Javan
• John Longo
• Todd Lawrence Jolly, DMD
• Judy L. Duncan, LCSW LLC
• Vlatka Juric
• Vasiliki Kalas, RPH

• Clinical Social Worker in Nutley, NJ
• Providers in Nutley, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.