Individual provider Active NPI

Jennifer L Theurer, LISW

  • Clinical Social Worker
  • North Liberty, IA
National Provider Identifier
1710247879
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
007573 Issued in IA
Practice address
1 Quail Creek Cir
North Liberty, IA 52317-9571
Phone
(319) 775-0074
Fax
(319) 774-6775
NPI assigned
May 23, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 007573 IA Primary

Addresses

Primary practice location

1 Quail Creek Cir
North Liberty, IA 52317-9571

Mailing address

27 Kearney CT
Iowa City, IA 52246-2799
Phone (319) 551-2498

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20151228001190 IA Practitioner - Clinical Social Worker 9335440932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Wellbeing Associates LLCGroup PAC ID 4385989102, 2 clinicians

Practice addresses (Care Compare)

1140 Tall Grass Ave
Tiffin, IA 52340-4753
Phone (319) 775-0074

27 Kearney CT
Iowa City, IA 52246-2799

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007573IAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Wellbeing Associates, LLC Clinical CurrentSince Nov 1, 2018 Accepting new patients

Locations

723 Pacha Pkwy
North Liberty, IA 52317
Phone (319) 775-0074

1 Quail Creek Cir
North Liberty, IA 52317
Phone (319) 775-0074

1140 Tall Grass Ave
Tiffin, IA 52340
Phone (319) 775-0074

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1710247879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 KEARNEY CT",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522462799",
            "telephone_number": "319-551-2498",
            "fax_number": "319-774-6775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 QUAIL CREEK CIR",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523179571",
            "telephone_number": "319-775-0074",
            "fax_number": "319-774-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEURER",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-23",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "007573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Liberty, IA

Sources for this page

Verify at the official NPI Registry.