Individual provider Active NPI

Rhonda Derusha

  • Social Worker
  • Shaker Heights, OH
National Provider Identifier
1366894065
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
20600 Chagrin Blvd Ste 900
Shaker Heights, OH 44122-5362
Phone
(216) 295-7239
Fax
(216) 295-7240
NPI assigned
Jul 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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 Primary

Addresses

Primary practice location

20600 Chagrin Blvd Ste 900
Shaker Heights, OH 44122-5362

Mailing address

20600 Chagrin Blvd Ste 900
Shaker Heights, OH 44122-5362
Phone (216) 295-7239

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

NPI Registry JSON

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

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467763200000",
    "number": "1366894065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20600 CHAGRIN BLVD STE 900",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441225362",
            "telephone_number": "216-295-7239",
            "fax_number": "216-295-7240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20600 CHAGRIN BLVD STE 900",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441225362",
            "telephone_number": "216-295-7239",
            "fax_number": "216-295-7240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERUSHA",
        "first_name": "RHONDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-06",
        "last_updated": "2016-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shaker Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2016; 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.