Active NPI
Jessica Shafer, LISW
- Social Worker
- Springfield, OH
National Provider Identifier
1861706178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- I.1500178
- Practice address
- 474 N Yellow Springs St
Springfield, OH 45504-2463 - Phone
- (937) 399-9500
- Fax
- (937) 342-4242
- NPI assigned
- Jul 28, 2010
- Sex
- Female
- Sole proprietor
- No
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 | I.1500178 | OH | Primary |
Addresses
Primary practice location
474 N Yellow Springs St
Springfield, OH 45504-2463
Mailing address
474 N Yellow Springs St
Springfield, OH 45504-2463
Phone (937) 399-9500
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 |
|---|---|---|---|
| I.1500178 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484265600000",
"number": "1861706178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "474 N YELLOW SPRINGS ST",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455042463",
"telephone_number": "937-399-9500",
"fax_number": "937-342-4242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "474 N YELLOW SPRINGS ST",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455042463",
"telephone_number": "937-399-9500",
"fax_number": "937-342-4242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFER",
"first_name": "JESSICA",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-28",
"last_updated": "2017-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "I.1500178",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.