Active NPI
Markida Jenise Roper
- Social Worker
- Carbondale, IL
National Provider Identifier
1093527871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 159106666
- Practice address
- 1150 E Grand Ave
Carbondale, IL 62901-3422 - Phone
- (618) 713-2786
- NPI assigned
- Jan 21, 2025
- Last updated
- Jan 21, 2025
- 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 | 159106666 | IL | Primary |
Addresses
Primary practice location
1150 E Grand Ave
Carbondale, IL 62901-3422
Mailing address
301 S Wall St
Carbondale, IL 62901-3240
Phone (618) 713-2786
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 |
|---|---|---|---|
| 159106666 | IL | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1737417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737417600000",
"number": "1093527871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 S WALL ST",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629013240",
"telephone_number": "618-713-2786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1150 E GRAND AVE",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629013422",
"telephone_number": "618-713-2786"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROPER",
"first_name": "MARKIDA",
"middle_name": "JENISE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-21",
"last_updated": "2025-01-21",
"certification_date": "2025-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "159106666",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carbondale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.