Individual provider Active NPI

Jolene Duggan

  • Clinical Social Worker
  • Bedford, MA
National Provider Identifier
1780813378
Registry record updated Jun 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
115651 Issued in MA
Practice address
200 Springs Rd
Bedford, MA 01730-1114
Phone
(781) 687-6000
NPI assigned
Jul 6, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 214737 MA
Clinical Social Worker 1041C0700X 115651 MA Primary

Addresses

Primary practice location

200 Springs Rd
Bedford, MA 01730-1114

Mailing address

200 Springs Rd
Bedford, MA 01730-1114
Phone (781) 687-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
214737MAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497312000000",
    "number": "1780813378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SPRINGS RD",
            "city": "BEDFORD",
            "state": "MA",
            "postal_code": "017301114",
            "telephone_number": "781-687-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SPRINGS RD",
            "city": "BEDFORD",
            "state": "MA",
            "postal_code": "017301114",
            "telephone_number": "781-687-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUGGAN",
        "first_name": "JOLENE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-06",
        "last_updated": "2017-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "214737",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "115651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, MA

Sources for this page

Verify at the official NPI Registry.