Individual provider Active NPI

Harmon Meldrim, LCSW-R

  • Clinical Social Worker
  • Hamburg, NY
National Provider Identifier
1245677657
Registry record updated May 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
069750-1 Issued in NY
Practice address
4472 Crestridge Dr
Hamburg, NY 14075-6504
Phone
(585) 738-3941
NPI assigned
May 24, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2013

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 069750-1 NY Primary

Addresses

Primary practice location

4472 Crestridge Dr
Hamburg, NY 14075-6504

Mailing address

4472 Crestridge Dr
Hamburg, NY 14075-6504
Phone (585) 738-3941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20191217001937 FL Practitioner - Clinical Social Worker 9436428240 Practice locations: Lady Lake, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
069750-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ultima Rehab-FL LLC CurrentSince Nov 14, 2019 Accepting new patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients

Locations

390 Pondella Rd
Ste 9
North Ft Myers, FL 33903
Phone (239) 652-0260

Interoperability endpoints

  • Direct secure messaging: harmonmeldrim@tdh.allscriptsdirect.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1369353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369353600000",
    "number": "1245677657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4472 CRESTRIDGE DR",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140756504",
            "telephone_number": "585-738-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4472 CRESTRIDGE DR",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140756504",
            "telephone_number": "585-738-3941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELDRIM",
        "first_name": "HARMON",
        "name_prefix": "Dr.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-24",
        "last_updated": "2013-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "069750-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamburg, NY

Sources for this page

Verify at the official NPI Registry.