Individual provider Active NPI

Jessica Rae Weits, LLMSW

  • Social Worker
  • Ionia, MI
National Provider Identifier
1891929600
Registry record updated May 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801085728 Issued in MI
Practice address
375 Apple Tree Dr
Ionia, MI 48846-7506
Phone
(616) 527-1790
NPI assigned
May 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801085728 MI Primary

Addresses

Primary practice location

375 Apple Tree Dr
Ionia, MI 48846-7506

Mailing address

1119 Atlantic St NW
Grand Rapids, MI 49504-4032
Phone (616) 776-2556

Other identifiers 1

IdentifierTypeStateIssuer
6801085728OtherMIMASTER'S SOCIAL WORKER LIMITED LICENSE

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

LicenseStateTypeSpecialty
6801085728MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Adolescent and Family Behavioral Health Services 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241654400000",
    "number": "1891929600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 ATLANTIC ST NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495044032",
            "telephone_number": "616-776-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 APPLE TREE DR",
            "city": "IONIA",
            "state": "MI",
            "postal_code": "488467506",
            "telephone_number": "616-527-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEITS",
        "first_name": "JESSICA",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-07",
        "last_updated": "2009-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801085728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASTER'S SOCIAL WORKER LIMITED LICENSE",
            "identifier": "6801085728",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ionia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2009; 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.