Individual provider Active NPI

Kristin L Jones, LCSW

  • Clinical Social Worker
  • Port Charlotte, FL
National Provider Identifier
1942565155
Registry record updated May 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW10196 Issued in FL
Practice address
1620 Tamiami TRL
Ste 216
Port Charlotte, FL 33948-4017
Phone
(941) 255-0405
NPI assigned
Jul 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2017

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 SW10196 FL Primary

Addresses

Primary practice location

1620 Tamiami TRL
Ste 216
Port Charlotte, FL 33948-4017

Mailing address

4060 Bruing St
North Port, FL 34286-2466
Phone (941) 220-8256

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120808000341 FL Practitioner - Clinical Social Worker 7113173063 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Align LLCGroup PAC ID 5092153478, 2 clinicians

Practice addresses (Care Compare)

209 Nassau St S
Suite 102
Venice, FL 34285-2358
Phone (888) 830-7849

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Align LLC Clinical CurrentSince Jan 27, 2024 Accepting new patients
Sean Higgins, DC, PA CurrentSince Jan 27, 2024 Accepting new patients
Millennium Physician Group LLC CurrentSince Mar 4, 2019 Accepting new patients
Millennium Physician Group LLC CurrentSince Mar 4, 2019 Accepting new patients
Nutegra Mental Health and Nutrition Inc Past Accepting new patients

Locations

14540 Cortez Blvd
Ste 102
Brooksville, FL 34613
Phone (352) 596-7255

3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108

2460 Tamiami Trl
Port Charlotte, FL 33952
Phone (941) 235-3444

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

1990 Main St
Ste 750
Sarasota, FL 34236
Phone (888) 830-7849

209 Nassau St S
Ste 102
Venice, FL 34285
Phone (888) 830-7849

Organizations & group practices 6

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": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495584000000",
    "number": "1942565155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 BRUING ST",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342862466",
            "telephone_number": "941-220-8256",
            "fax_number": "941-237-5808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 TAMIAMI TRL",
            "address_2": "STE 216",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339484017",
            "telephone_number": "941-255-0405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "KRISTIN",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-13",
        "last_updated": "2017-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW10196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.