Active NPI
Shannon Spellman
- Social Worker
- Saint Louis, MO
National Provider Identifier
1043564073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 2012029334
- Practice address
- 1919 S Grand Blvd
Saint Louis, MO 63104-1571 - Phone
- (314) 566-5268
- NPI assigned
- Oct 29, 2012
- 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 | 2012029334 | MO | Primary |
Addresses
Primary practice location
1919 S Grand Blvd
Saint Louis, MO 63104-1571
Mailing address
4441 Skyridge Dr
Saint Louis, MO 63128-2445
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 |
|---|---|---|---|
| 2012029334 | MO | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351468800000",
"number": "1043564073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4441 SKYRIDGE DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631282445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1919 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041571",
"telephone_number": "314-566-5268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPELLMAN",
"first_name": "SHANNON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-29",
"last_updated": "2012-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MO",
"license": "2012029334",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.