Jennifer Lynn Emmerich, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801084037 Issued in MI

Practice address

6446 Sr 179
Suite 207-B
Sedona, AZ 86351-7990

Phone

(928) 451-4572

NPI assigned

Jul 14, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

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, 1998

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.

• Thomas H. Vandoren

  • Psychosomatic Medicine Physician
  • Kalamazoo, MI
  • NPI 1124244157
  NPD (past)

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489708800000",
    "number": "1740206903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 REDROCK RD",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863518656",
            "telephone_number": "928-451-4572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6446 SR 179",
            "address_2": "SUITE 207-B",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863517990",
            "telephone_number": "928-451-4572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMMERICH",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2017-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801084037",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "15771",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEM",
            "identifier": "9354452",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "BCBS",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kenneth Andrii Ervin-Beckford
• Eye Boutique of Sedona, PLLC
• Fab-Motion LLC
• Jeffrey Farnham, DC

• Clinical Social Worker in Sedona, AZ
• Providers in Sedona, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; 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.