Individual provider Active NPI

Jerome R. Sachs, M.S.W.

  • Clinical Social Worker
  • Chevy Chase, MD
National Provider Identifier
1881742559
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5447 Issued in MD
Practice address
5480 Wisconsin Ave Ste 220
Chevy Chase, MD 20815-3525
Phone
(301) 718-0402
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 5447 MD Primary
Clinical Social Worker 1041C0700X LC300176 DC

Addresses

Primary practice location

5480 Wisconsin Ave Ste 220
Chevy Chase, MD 20815-3525

Mailing address

11 Devon Rd
Silver Spring, MD 20910-5441
Phone (301) 718-0402

Other identifiers 2

IdentifierTypeStateIssuer
5447OtherMDMARYLAND LICENSE NUMBER
LC300176OtherDCDC LICENSE NUMBER

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC300176DCMDClinical Social Worker
5447MDMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881742559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 DEVON RD",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209105441",
            "telephone_number": "301-718-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 WISCONSIN AVE STE 220",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208153525",
            "telephone_number": "301-718-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACHS",
        "first_name": "JEROME",
        "middle_name": "R.",
        "credential": "M.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "5447",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC300176",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND LICENSE NUMBER",
            "identifier": "5447",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DC LICENSE NUMBER",
            "identifier": "LC300176",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chevy Chase, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.