Active NPI
Riley Mekelburg
- Social Worker
- Greeley, CO
National Provider Identifier
1053866301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LSW.0009921743
- Practice address
- 1300 N 17TH Ave
Greeley, CO 80631-9584 - Phone
- (970) 347-2120
- NPI assigned
- Aug 16, 2016
- Last updated
- Dec 22, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | BA | CO | |
| Social Worker | 104100000X | LSW.0009921743 | CO | Primary |
Addresses
Primary practice location
1300 N 17TH Ave
Greeley, CO 80631-9584
Mailing address
1300 N 17TH Ave
Greeley, CO 80631-9584
Phone (970) 347-2120
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 |
|---|---|---|---|
| BA | CO | MD | Social Worker |
| LSW.0009921743 | CO | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513900800000",
"number": "1053866301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 N 17TH AVE",
"city": "GREELEY",
"state": "CO",
"postal_code": "806319584",
"telephone_number": "970-347-2120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 N 17TH AVE",
"city": "GREELEY",
"state": "CO",
"postal_code": "806319584",
"telephone_number": "970-347-2120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEKELBURG",
"first_name": "RILEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-16",
"last_updated": "2017-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CO",
"license": "BA",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CO",
"license": "LSW.0009921743",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greeley, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.