Individual provider Active NPI

Jeffrey Clark Anglin, MSW

  • Addiction (Substance Use Disorder) Counselor
  • Sarasota, FL
National Provider Identifier
1720315740
Registry record updated Nov 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
SR-58-AD-6109-01 Issued in FL
Practice address
1990 Main St Ste 750
Sarasota, FL 34236-8000
Phone
(941) 951-2666
Fax
(941) 951-2666
NPI assigned
Nov 12, 2009
Last updated
Nov 12, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X SR-58-AD-6109-01 FL Primary

Addresses

Primary practice location

1990 Main St Ste 750
Sarasota, FL 34236-8000

Mailing address

2282 Arlington St
Sarasota, FL 34239-2441
Phone (941) 951-2666

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SR-58-AD-6109-01FLMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center Past Accepting new patients

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, 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": "1257984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257984000000",
    "number": "1720315740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2282 ARLINGTON ST",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392441",
            "telephone_number": "941-951-2666",
            "fax_number": "941-951-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 MAIN ST STE 750",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342368000",
            "telephone_number": "941-951-2666",
            "fax_number": "941-951-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGLIN",
        "first_name": "JEFFREY",
        "middle_name": "CLARK",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-12",
        "last_updated": "2009-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "SR-58-AD-6109-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2009; 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.