Active NPI
Rose M Odemba
- Social Worker
- Canton, OH
National Provider Identifier
1720577349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S1701830
- Practice address
- 832 McKinley Ave NW
Canton, OH 44703-2463 - Phone
- (330) 452-9812
- Fax
- (330) 430-1288
- NPI assigned
- May 9, 2018
- 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 | S1701830 | OH | Primary |
Addresses
Primary practice location
832 McKinley Ave NW
Canton, OH 44703-2463
Mailing address
832 McKinley Ave NW
Canton, OH 44703-2463
Phone (330) 452-9812
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 |
|---|---|---|---|
| S1701830 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525824000000",
"number": "1720577349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "832 MCKINLEY AVE NW",
"city": "CANTON",
"state": "OH",
"postal_code": "447032463",
"telephone_number": "330-452-9812",
"fax_number": "330-430-1288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "832 MCKINLEY AVE NW",
"city": "CANTON",
"state": "OH",
"postal_code": "447032463",
"telephone_number": "330-452-9812",
"fax_number": "330-430-1288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODEMBA",
"first_name": "ROSE",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-09",
"last_updated": "2018-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S1701830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.