Individual provider Active NPI

Jamy Dean Vansyckle, LCSW

  • Clinical Social Worker
  • Kansas City, MO
National Provider Identifier
1972813764
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2010011399 Issued in MO
Practice address
3101 Broadway Blvd
Kansas City, MO 64111-2659
Phone
(816) 302-3700
Fax
(816) 302-9939
NPI assigned
Oct 14, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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 2010011399 MO Primary

Addresses

Primary practice location

3101 Broadway Blvd
Kansas City, MO 64111-2659

Mailing address

2401 Gillham Rd
Provider Enrollment Dept
Kansas City, MO 64108-4619
Phone (816) 234-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20240930001641 MO Practitioner - Clinical Social Worker 3274064423 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2010011399MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Children'S Mercy Hospital CurrentSince Sep 23, 2024 Accepting new patients
The Children'S Mercy Hospital CurrentSince Sep 23, 2024 Accepting new patients

Locations

3101 Broadway Blvd
Kansas City, MO 64111
Phone (816) 302-3700

2401 Gillham Rd
Kansas City, MO 64108
Phone (816) 234-3380

Organizations & group practices 2

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": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1972813764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "address_2": "PROVIDER ENROLLMENT DEPT",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-234-3000",
            "fax_number": "816-302-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 BROADWAY BLVD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641112659",
            "telephone_number": "816-302-3700",
            "fax_number": "816-302-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANSYCKLE",
        "first_name": "JAMY",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-14",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2010011399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.