Individual provider Active NPI

Melanie Rodman

  • Clinical Social Worker
  • Ballwin, MO
National Provider Identifier
1093246449
Registry record updated Mar 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2008029734 Issued in MO
Practice address
301 Sovereign CT
Suite 110
Ballwin, MO 63011-4441
Phone
(314) 329-8580
NPI assigned
Mar 27, 2017
Last updated
Mar 27, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2017

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 2008029734 MO Primary

Addresses

Primary practice location

301 Sovereign CT
Suite 110
Ballwin, MO 63011-4441

Mailing address

301 Sovereign CT
Suite 110
Ballwin, MO 63011-4441
Phone (314) 329-8580

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

LicenseStateTypeSpecialty
2008029734MOMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490572800000",
    "number": "1093246449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SOVEREIGN CT",
            "address_2": "SUITE 110",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114441",
            "telephone_number": "314-329-8580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SOVEREIGN CT",
            "address_2": "SUITE 110",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114441",
            "telephone_number": "314-329-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODMAN",
        "first_name": "MELANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2017-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2008029734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballwin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.

Verify at the official NPI Registry.