Active NPI
Danielle Jillian Waddle, LMSW
- Social Worker
- Rock Island, IL
National Provider Identifier
1013475334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 091225
- Practice address
- 2701 17TH St
Rock Island, IL 61201-5351 - Phone
- (309) 779-2031
- NPI assigned
- Mar 5, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 091225 | IA | Primary |
Addresses
Primary practice location
2701 17TH St
Rock Island, IL 61201-5351
Mailing address
2701 17TH St
Rock Island, IL 61201-5351
Phone (309) 779-2031
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
| License | State | Type | Specialty |
|---|---|---|---|
| 091225 | IA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551744000000",
"number": "1013475334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2701 17TH ST",
"city": "ROCK ISLAND",
"state": "IL",
"postal_code": "612015351",
"telephone_number": "309-779-2031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 17TH ST",
"city": "ROCK ISLAND",
"state": "IL",
"postal_code": "612015351",
"telephone_number": "309-779-2031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADDLE",
"first_name": "DANIELLE",
"middle_name": "JILLIAN",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-05",
"last_updated": "2019-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IA",
"license": "091225",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rock Island, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.