Organization Active NPI

Mary Jo Dempsey PC

  • Clinical Social Worker
  • Muskegon, MI
National Provider Identifier
1780765271
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801033857 Issued in MI
Legal business name
MARY JO DEMPSEY PC
Practice address
1735 Peck St
Muskegon, MI 49441-2507
Phone
(231) 722-8500
Fax
(517) 579-0272
NPI assigned
Oct 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Mary Jo Dempsey, MSW
Title
Owner
Phone
(231) 722-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 6801033857 MI Primary

Addresses

Primary practice location

1735 Peck St
Muskegon, MI 49441-2507

Mailing address

5124 Brookwood Cir
Montague, MI 49437-1001
Phone (231) 894-5011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070103000038 MI Part B Supplier - Clinic/Group Practice 1355341041 Receives reassigned benefits from 1 practitioner
Practice locations: Norton Shores, MI

National Provider Directory

National Provider Directory

Locations

800 E Ellis Rd
Ste 221
Norton Shores, MI 49441
Phone (231) 722-8500

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780765271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5124 BROOKWOOD CIR",
            "city": "MONTAGUE",
            "state": "MI",
            "postal_code": "494371001",
            "telephone_number": "231-894-5011",
            "fax_number": "517-579-0272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 PECK ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494412507",
            "telephone_number": "231-722-8500",
            "fax_number": "517-579-0272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY JO DEMPSEY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEMPSEY",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-722-8500",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801033857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.