Jennifer Runyan

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

22003 Issued in FL

Practice address

550 SE 6TH Ave # 200
Delray Beach, FL 33483-5306

Phone

(561) 396-9649

NPI assigned

May 23, 2024

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 FL, DE, MN, MA, TX5 enrollments

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 5

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, DE, MA, MN, TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1740029115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 SW 8TH ST # 1145",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334265827",
            "telephone_number": "561-396-9649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 SE 6TH AVE # 200",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334835306",
            "telephone_number": "561-396-9649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNYAN",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-23",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "22003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Anne Rudolph, FNP
• Jorge Luis Ruiz Perez, RBT
• Lianet Ruiz Perez
• Andres Felipe Ruiz, M.D.
• Jeannina Ruiz, LPC, LMHC, NCC
• Deborah R Russ, MPS
• Seena Ann Russell Axel, PSYCHOTHERAPIST
• William M Russell, MD
• Amanda Lauren Russo
• Frank M. Russo, M.D.

• Clinical Social Worker in Delray Beach, FL
• Providers in Delray Beach, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.