Active NPI
Jennifer Renee Willoughby, LMSW
- Social Worker
- Oak Ridge, TN
National Provider Identifier
1780407627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 0000014869
- Practice address
- 115 Fairbanks Rd
Oak Ridge, TN 37830-7052 - Phone
- (865) 482-6098
- NPI assigned
- Nov 7, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 0000014869 | TN | Primary |
Addresses
Primary practice location
115 Fairbanks Rd
Oak Ridge, TN 37830-7052
Mailing address
147 McGhee LN
Jacksboro, TN 37757-4508
Phone (615) 636-3358
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000014869 | TN | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730937600000",
"number": "1780407627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 MCGHEE LN",
"city": "JACKSBORO",
"state": "TN",
"postal_code": "377574508",
"telephone_number": "615-636-3358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 FAIRBANKS RD",
"city": "OAK RIDGE",
"state": "TN",
"postal_code": "378307052",
"telephone_number": "865-482-6098"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLOUGHBY",
"first_name": "JENNIFER",
"middle_name": "RENEE",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-11-07",
"last_updated": "2024-11-07",
"certification_date": "2024-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "TN",
"license": "0000014869",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Ridge, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.