Active NPI
Sierra Jane De Mello, LMSW
- Social Worker
- Twin Falls, ID
National Provider Identifier
1700664802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 442460
- Practice address
- 2550 Addison Ave E Ste G
Twin Falls, ID 83301-6748 - Phone
- (208) 814-7750
- NPI assigned
- Sep 19, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 442460 | ID | Primary |
Addresses
Primary practice location
2550 Addison Ave E Ste G
Twin Falls, ID 83301-6748
Mailing address
701 21St Ave E
Jerome, ID 83338-4937
Phone (208) 358-3107
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
| License | State | Type | Specialty |
|---|---|---|---|
| 442460 | ID | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Luke'S Clinic LLC | Past | Accepting new patients | |
| St Luke'S Magic Valley Regional Medical Center LTD | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Twin Falls, ID
- NPI 1790718229
-
- Community/Retail Pharmacy
- Twin Falls, ID
- NPI 1760203921
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695081600000",
"number": "1700664802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 21ST AVE E",
"city": "JEROME",
"state": "ID",
"postal_code": "833384937",
"telephone_number": "208-358-3107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2550 ADDISON AVE E STE G",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833016748",
"telephone_number": "208-814-7750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE MELLO",
"first_name": "SIERRA",
"middle_name": "JANE",
"name_prefix": "Mrs.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-19",
"last_updated": "2023-09-19",
"certification_date": "2023-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ID",
"license": "442460",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Twin Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.