Individual provider Active NPI

Melissa Leigh Dedie

  • Social Worker
  • Battle Creek, MI
National Provider Identifier
1356670210
Registry record updated Dec 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6301014064 Issued in MI
Practice address
140 Michigan Ave W
Battle Creek, MI 49017-3602
Phone
(269) 966-1460
Fax
(269) 979-7766
NPI assigned
Dec 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6301014064 MI Primary

Addresses

Primary practice location

140 Michigan Ave W
Battle Creek, MI 49017-3602

Mailing address

140 Michigan Ave W
Battle Creek, MI 49017-3602
Phone (269) 966-1460

Other identifiers 1

IdentifierTypeStateIssuer
6301014064OtherMISTATE LIC #

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
6301014064MIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1261526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261526400000",
    "number": "1356670210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 MICHIGAN AVE W",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490173602",
            "telephone_number": "269-966-1460",
            "fax_number": "269-979-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 MICHIGAN AVE W",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490173602",
            "telephone_number": "269-966-1460",
            "fax_number": "269-979-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEDIE",
        "first_name": "MELISSA",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-23",
        "last_updated": "2009-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6301014064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC #",
            "identifier": "6301014064",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2009; 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.