Katelyn Mary Jakovenko

Primary specialty

Social WorkerTaxonomy code 104100000X

License

13570 Issued in TN

Practice address

301 Wolverine TRL Ste 200
Smyrna, TN 37167-5656

Phone

(615) 751-0579

NPI assigned

Nov 21, 2022

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 TN

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, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/sperohealth/r4/

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.

• Spero Health of Tennessee, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Smyrna, TN
  • NPI 1538628904
  Medicare reassignment NPD

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

{
    "created_epoch": "1668988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1780393413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 AIRWAYS CIR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372143608",
            "telephone_number": "606-481-0371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 WOLVERINE TRL STE 200",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371675656",
            "telephone_number": "615-751-0579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAKOVENKO",
        "first_name": "KATELYN",
        "middle_name": "MARY",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-21",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TN",
            "license": "13570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antonia Jackson
• Jennifer J Jackson, M.ED., CCC-SLP
• Latanya Jackson, HEALTHCARE ADMIN
• Salimeh Jackson
• Tyera Ryanne Jackson
• Vana Z Jamal
• Jasmine James
• Paris Lemar Jarman, DDS
• Katherine Jordan Jeffcoat
• Jefferson Cosmetic Surgery Clinic, PLLC

• Social Worker in Smyrna, TN
• Providers in Smyrna, TN by specialty
• Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.