Individual provider Active NPI

Jessica Grant, LICSW

  • Clinical Social Worker
  • Worthington, MN
National Provider Identifier
1700210226
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1680 Diagonal Rd
Worthington, MN 56187-1008
Phone
(507) 372-3800
NPI assigned
Sep 3, 2013
Last updated
Dec 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 008365 IA
Clinical Social Worker 1041C0700X MN Primary

Addresses

Primary practice location

1680 Diagonal Rd
Worthington, MN 56187-1008

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-9419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20170914003158 MN Practitioner - Clinical Social Worker 8426322470 Reassigns benefits to 2 organizations

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
Sanford Health NetworkGroup PAC ID 6800707100, 357 clinicians

Practice addresses (Care Compare)

1018 6TH Ave
Worthington, MN 56187-2202
Phone (507) 372-3800

1680 Diagonal Rd
Worthington, MN 56187-1008
Phone (507) 372-3800

Merit-based Incentive Payment System (MIPS)

Final score
85.53 of 100Reported as group
Quality
80.98
Promoting interoperability
100
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008365IAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health Network Current Accepting new patients
Sanford Health Network CurrentSince Jan 26, 2020 Accepting new patients
Southwestern Mental Health Center Inc CurrentSince Dec 12, 2022 Accepting new patients
Sanford Health Network CurrentSince Jan 26, 2020 Accepting new patients
Sanford Health Network Current Accepting new patients

Locations

1430 North Hwy
Jackson, MN 56143
Phone (507) 847-2200

117 S Spring St
Luverne, MN 56156
Phone (507) 283-9511

249 5th St E
Tracy, MN 56175
Phone (507) 629-3520

1018 6th Ave
Worthington, MN 56187
Phone (507) 343-6100

1680 Diagonal Rd
Worthington, MN 56187
Phone (507) 372-3800

Organizations & group practices 5

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": "1378166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1700210226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-9419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 DIAGONAL RD",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561871008",
            "telephone_number": "507-372-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "JESSICA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-03",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "008365",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worthington, MN

Sources for this page

Verify at the official NPI Registry.