Individual provider Active NPI

Jill Marlene Nance, LCSW

  • Social Worker
  • Port St Joe, FL
National Provider Identifier
1932357316
Registry record updated Jan 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SW 9733 Issued in FL
Practice address
2475 Garrison Ave
Port St Joe, FL 32456-5265
Phone
(850) 227-1276
Fax
(850) 227-1497
NPI assigned
Aug 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2010

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 SW 9733 FL Primary

Addresses

Primary practice location

2475 Garrison Ave
Port St Joe, FL 32456-5265

Mailing address

2475 Garrison Ave
Port St Joe, FL 32456-5265
Phone (850) 227-1276

Other identifiers 1

IdentifierTypeStateIssuer
0000000000OtherHAS NOT BEEN ISSUED ANY NUMBERS

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
SW 9733FLMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264464000000",
    "number": "1932357316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 GARRISON AVE",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324565265",
            "telephone_number": "850-227-1276",
            "fax_number": "850-227-1497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 GARRISON AVE",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324565265",
            "telephone_number": "850-227-1276",
            "fax_number": "850-227-1497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANCE",
        "first_name": "JILL",
        "middle_name": "MARLENE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-28",
        "last_updated": "2010-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "SW 9733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAS NOT BEEN ISSUED ANY NUMBERS",
            "identifier": "0000000000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Joe, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2010; 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.