Roxanne Waldron

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

1200 N West Ave Ste 300
Jackson, MI 49202-2180

Phone

(517) 789-1234

Fax

(517) 740-7040

NPI assigned

Feb 6, 2019

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

Other names 1

• Roxanne Shankster Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Integro LLC

  • Mental Health Counselor
  • Jackson, MI
  • NPI 1457413460
  NPD (past)

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1376008045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 WILSON ST",
            "city": "MORENCI",
            "state": "MI",
            "postal_code": "492561130",
            "telephone_number": "517-306-3516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N WEST AVE STE 300",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022180",
            "telephone_number": "517-789-1234",
            "fax_number": "517-740-7040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Care Dr Ste 231",
            "address_purpose": "LOCATION",
            "city": "Hillsdale",
            "state": "MI",
            "postal_code": "492425054",
            "country_code": "US",
            "telephone_number": "517-439-2609 x2613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALDRON",
        "first_name": "ROXANNE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROXANNE",
            "last_name": "SHANKSTER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Susan Marie Waite, NBC-HIS
• Wal-Mart Stores East , LP
• Wal-Mart Stores East, LP
• John Joseph Wald, M.D.
• Audrey Waldo
• Walgreen Co
• Walgreen Co
• Frances Walicki
• Alisha Ann Walker
• David R Walker, PA

• Clinical Social Worker in Jackson, MI
• Providers in Jackson, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; 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.