Individual provider Active NPI

Jason Conger, LCSW, LMFT

  • Clinical Social Worker
  • Wheat Ridge, CO
National Provider Identifier
1750783163
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
09923511 Issued in CO
Practice address
4891 Independence St Ste 165
Wheat Ridge, CO 80033-6714
Phone
(303) 456-0600
NPI assigned
Sep 17, 2014
Last updated
Nov 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 09923511 CO Primary
Marriage & Family Therapist 106H00000X 1159 CO

Addresses

Primary practice location

4891 Independence St Ste 165
Wheat Ridge, CO 80033-6714

Mailing address

4891 Independence St Ste 165
Wheat Ridge, CO 80033-6714
Phone (303) 456-0600

Other practice location 1

2450 S Peoria St Ste 245
Aurora, CO 80014-5475
Phone (303) 752-7732

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20201125001017 CO Practitioner - Clinical Social Worker 3274944160 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
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

2450 S Peoria
Suite 245 Uchmg Virtual Visit
Aurora, CO 80014-5475
Phone (303) 752-7732

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1159COMDProfessional Counselor
09923511COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Aug 25, 2020 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Aug 25, 2020 Accepting new patients
Poudre Valley Medical Group, LLC PastSince Sep 20, 2020 Accepting new patients

Locations

2450 S Peoria St
Ste 245
Aurora, CO 80014
Phone (303) 752-7732

2450 S Peoria St
Ste 245UCHMG
Aurora, CO 80014
Phone (303) 752-7732

2450 S Peoria St
Ste 248
Aurora, CO 80014
Phone (303) 752-7747

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1750783163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4891 INDEPENDENCE ST STE 165",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336714",
            "telephone_number": "303-456-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4891 INDEPENDENCE ST STE 165",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336714",
            "telephone_number": "303-456-0600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2450 S Peoria St Ste 245",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800145475",
            "country_code": "US",
            "telephone_number": "303-752-7732",
            "fax_number": "720-848-9112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONGER",
        "first_name": "JASON",
        "credential": "LCSW, LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-17",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "09923511",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CO",
            "license": "1159",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

Verify at the official NPI Registry.