Robert Farrelly

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2013037930 Issued in MO

Practice address

621 S New Ballas Rd
#112A
Saint Louis, MO 63141-8232

Phone

(314) 779-9500

NPI assigned

Feb 4, 2014

Sex

Male

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• 180 Health Partners , Inc

  • Clinical Social Worker
  • Nashville, TN
  • NPI 1851811830

  Clinical, MO

  Medicare reassignment NPD
• Axis Healthcare Group

  • Psychiatry Physician
  • Silver Spring, MD
  • NPI 1326295098

  MO

  Medicare reassignment NPD
• Mindoula Health Inc.

  • Community/Behavioral Health Agency
  • Silver Spring, MD
  • NPI 1558843813

  MO, TX

  Medicare reassignment NPD
• MCS, PC

  • Community/Behavioral Health Agency
  • Silver Spring, MD
  • NPI 1538717723

  IN, MO

  Medicare reassignment
• Advanced Wound Therapy-TN PLLC

  • Family Medicine Physician
  • Franklin, TN
  • NPI 1609760339
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in MO, TX, IN3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 22, 2024.

{
    "created_epoch": "1391472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1104249622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "#112A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-779-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "#112A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-779-9500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Cityplace Dr Ste 2",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631417390",
            "country_code": "US",
            "telephone_number": "888-879-9786",
            "fax_number": "888-511-3073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARRELLY",
        "first_name": "ROBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-04",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2013037930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanna Suzanne Farrell
• John S Farrell, M.D.
• Kaitlin A Farrell, M.D
• Kevin Farrell
• Nyssa Fox Farrell, MD
• Marjorie Ann Farrington, MD
• Emalee Ann Farris, PA-C
• Caroline Farroll
• Jason Michael Farrow, MD
• Ayesha Farrukh

• All providers in Saint Louis, MO
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.