Individual provider Active NPI

Melanie Rose

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1427695295
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801117765 Issued in MI
Practice address
3005 Boardwalk St Ste 201
Ann Arbor, MI 48108-5218
Phone
(734) 222-9277
NPI assigned
Nov 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Technician/Technologist 156F00000X
Clinical Social Worker 1041C0700X 6801117765 MI Primary

Addresses

Primary practice location

3005 Boardwalk St Ste 201
Ann Arbor, MI 48108-5218

Mailing address

3005 Boardwalk St Ste 201
Ann Arbor, MI 48108-5218

Other practice location 1

32100 Telegraph Rd Ste 205
Bingham Farms, MI 48025-2454
Phone (248) 712-4266

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
6801117765MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1574899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1427695295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3005 BOARDWALK ST STE 201",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481085218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 BOARDWALK ST STE 201",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481085218",
            "telephone_number": "734-222-9277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "32100 Telegraph Rd Ste 205",
            "address_purpose": "LOCATION",
            "city": "Bingham Farms",
            "state": "MI",
            "postal_code": "480252454",
            "country_code": "US",
            "telephone_number": "248-712-4266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "MELANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-28",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156F00000X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801117765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.