Individual provider Active NPI

Jennifer Reid, LSCSW

  • Clinical Social Worker
  • Wichita, KS
National Provider Identifier
1790906444
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1691 Issued in KS
Practice address
643 N Armour St
Wichita, KS 67206-1515
Phone
(316) 304-3873
Fax
(949) 862-1619
NPI assigned
May 1, 2007
Last updated
Aug 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1691 KS Primary

Addresses

Primary practice location

643 N Armour St
Wichita, KS 67206-1515

Mailing address

643 N Armour St
Wichita, KS 67206-1515
Phone (316) 304-3873

Other practice location 1

643 N Armour St
Wichita, KS 67206-1515
Phone (316) 304-3873

Other identifiers 2

IdentifierTypeStateIssuer
0000068522OtherKSBLUE CROSS BLUE SHIELD
100337160 AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20050411000921 KS Practitioner - Clinical Social Worker 8224075353 Practice locations: Wichita, KS

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

643 N Armour St
Wichita, KS 67206-1515
Phone (316) 304-3873

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1691KSMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dawn Robinson, Lscsw, LLC Clinical Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1790906444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "643 N ARMOUR ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672061515",
            "telephone_number": "316-304-3873",
            "fax_number": "949-862-1619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "643 N ARMOUR ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672061515",
            "telephone_number": "316-304-3873",
            "fax_number": "949-862-1619"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "643 N Armour St",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672061515",
            "country_code": "US",
            "telephone_number": "316-304-3873",
            "fax_number": "949-862-1619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REID",
        "first_name": "JENNIFER",
        "credential": "LSCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "1691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0000068522",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100337160 A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.