Individual provider Active NPI

Georgean Rustemeyer, MSW, LCSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1629788187
Registry record updated Nov 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
001092 Issued in MO
Practice address
1215 Fern Ridge Pkwy Ste 110
Saint Louis, MO 63141-4405
Phone
(314) 690-7804
NPI assigned
Nov 24, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2022

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 001092 MO Primary

Addresses

Primary practice location

1215 Fern Ridge Pkwy Ste 110
Saint Louis, MO 63141-4405

Mailing address

1215 Fern Ridge Pkwy Ste 110
Saint Louis, MO 63141-4405
Phone (314) 275-8599

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Madmar, LLC CurrentSince Jun 9, 2024 Accepting new patients

Locations

1215 Fern Ridge Pkwy
Ste 110
Saint Louis, MO 63141
Phone (314) 275-8599

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": "1669248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669248000000",
    "number": "1629788187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 FERN RIDGE PKWY STE 110",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631414405",
            "telephone_number": "314-275-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 FERN RIDGE PKWY STE 110",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631414405",
            "telephone_number": "314-690-7804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSTEMEYER",
        "first_name": "GEORGEAN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-24",
        "last_updated": "2022-11-24",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "001092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.