Jodie Roback

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

203 E Cayuga St
Bellaire, MI 49615-9180

Phone

(231) 533-8619

NPI assigned

Oct 30, 2017

Last updated

Oct 30, 2017By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Country Community Mental HealthGroup PAC ID 8820052095, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Country Community Mental Health

  • Community/Behavioral Health Agency
  • Petoskey, MI
  • NPI 1053474015
  Medicare reassignment Care Compare group NPD
• North Country Community Mental Health

  • Community/Behavioral Health Agency
  • Petoskey, MI
  • NPI 1881060549
  NPD (past)

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

{
    "created_epoch": "1509321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509321600000",
    "number": "1689186744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220",
            "city": "BELLAIRE",
            "state": "MI",
            "postal_code": "496150220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 E CAYUGA ST",
            "city": "BELLAIRE",
            "state": "MI",
            "postal_code": "496159180",
            "telephone_number": "231-533-8619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBACK",
        "first_name": "JODIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-30",
        "last_updated": "2017-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prevos Family Markets LLC (Family Fare Pharmacy 645)
• Janice Aura Proudfoot, LMSW
• Brian K Rathke, DDS
• Katherine Irene Rathke, DDS
• Margaret Rathke, DDS
• Adam William Wayne Schwarz, D.C.
• Kaleigh Anna Sharlene Shepard, LLMSW
• Marissa M Slabosz, TLLP
• Paul James Taylor, MA, CCC-SLP
• Township Ambulance Authority

• Social Worker in Bellaire, MI
• Providers in Bellaire, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.