Nedra Lynn Tanksley, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2001014357 Issued in MO

Practice address

1465 S Grand Blvd
Saint Louis, MO 63104-1003

Phone

(314) 268-5700

NPI assigned

Dec 3, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• SSM Cardinal Glennon Childrens Hospital

  • Pediatrics Physician
  • O Fallon, IL
  • NPI 1174577670

  MO

  Medicare reassignment NPD
• SSM Cardinal Glennon Children'S Hospital

  • Pediatrics Physician
  • Warrenton, MO
  • NPI 1962573212
  NPD
• Epworth Children & Family Services

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Saint Louis, MO
  • NPI 1255488623
  NPD (past)

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1265037428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3648 FLAD AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631104022",
            "telephone_number": "636-236-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-268-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANKSLEY",
        "first_name": "NEDRA",
        "middle_name": "LYNN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-03",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2001014357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tony Thien Tang, M. D.
• Yunshuo Tang, MD
• Toshibumi Taniguchi, M.D.
• Aline T Tanios, MD
• Ashley Adele Tankersley, D.C.
• Melvin Avon Tann, ACSW, LCSW
• Deborah L Tannenbaum, MSW, LCSW
• Marilyn Kaye Tanner-Blasiar, RD
• Sadie Tanner-Pobocik, LPC
• Andrew Tanous

• Clinical Social Worker in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2022; 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.