Justin David Jeffrey

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

22560 Issued in MN

Practice address

6550 York Ave S Ste 417
Edina, MN 55435-2336

Phone

(952) 426-3034

NPI assigned

Oct 1, 2015

Last updated

Jan 31, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Mary Mullenbach PHD LP IncGroup PAC ID 5799950283, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mary Mullenbach, PHD, LP, Inc

  dba Legacy Mental Health Center

  • Psychologist
  • Edina, MN
  • NPI 1801182837
  Medicare reassignment Care Compare group NPD
• Fairview Express Care

  dba M Health Fairview Recovery Clinic

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment NPD
• Healtheast Medical Research Institute

  dba HealthEast Vadnais Heights Clinic

  • Clinic/Center
  • Vadnais Heights, MN
  • NPI 1639125503
  Medicare reassignment NPD
• Healtheast St. John's Hospital

  dba Fairview St John's Hospital

  • General Acute Care Hospital
  • Maplewood, MN
  • NPI 1447218482
  Medicare reassignment NPD
• Healtheast Woodwinds Hospital

  dba Fairview Woodwinds Hospital

  • General Acute Care Hospital
  • Woodbury, MN
  • NPI 1356309322
  Medicare reassignment NPD
• Fairview Express Care

  dba Fairview Clinics Specialty

  • Specialist
  • Saint Paul, MN
  • NPI 1679048763
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• Healtheast Medical Research Institute

  dba HealthEast Professional Services

  • Internal Medicine Physician
  • Saint Paul, MN
  • NPI 1508191552

  Clinical

  NPD
• Healtheast Medical Research Institute

  dba HealthEast Rice Street Clinic

  • Clinic/Center
  • Saint Paul, MN
  • NPI 1578503124
  NPD
• Healtheast Medical Research Institute

  dba HealthEast Surgery

  • Surgery Physician
  • Maplewood, MN
  • NPI 1750791810
  NPD

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

{
    "created_epoch": "1443657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1942670039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6550 YORK AVE S STE 417",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352336",
            "telephone_number": "952-426-3034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 YORK AVE S STE 417",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352336",
            "telephone_number": "952-426-3034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFREY",
        "first_name": "JUSTIN",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-01",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jay Mar Opticians, Inc
• Ravi Sankara Reddy Jayavarapu, MBBS MPH
• Jed James Psychotherapy
• Shannon Elaine Jedlicka, RD, LD
• Alina Jeffers, MD
• Matthew G. Jelinek, D.D.S.
• Andrea Roxanna Jenkins-Whitmore
• Jonathan M Jenkins, D.D.S., M.D.
• Lenny Lawrence Jennings, PH.D, L.P.
• Richard Jennis, MD

• Clinical Social Worker in Edina, MN
• Providers in Edina, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.