Individual provider Active NPI

Dennis Rody, MSW, LCSW, ACSW

  • Clinical Social Worker
  • Waukesha, WI
National Provider Identifier
1629099700
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1884-123 Issued in WI
Practice address
400 W Moreland Blvd
Waukesha, WI 53188-2412
Phone
(262) 524-9416
Fax
(262) 524-9434
NPI assigned
Jul 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1884-123 WI Primary

Addresses

Primary practice location

400 W Moreland Blvd
Waukesha, WI 53188-2412

Mailing address

285 N Janacek Rd
Brookfield, WI 53045-6102
Phone (262) 641-9050

Other identifiers 1

IdentifierTypeStateIssuer
39633500MedicaidWI

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1884-123WIMDClinical Social Worker
1884WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Healthcare, Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629099700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 N JANACEK RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530456102",
            "telephone_number": "262-641-9050",
            "fax_number": "262-641-9126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W MORELAND BLVD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531882412",
            "telephone_number": "262-524-9416",
            "fax_number": "262-524-9434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODY",
        "first_name": "DENNIS",
        "credential": "MSW, LCSW, ACSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "1884-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39633500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.