Active NPI
Melissa Stromberger
- Clinical Psychologist
- Davenport, IA
National Provider Identifier
1750760252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 001293
- Practice address
- 4455 E 56TH St
Davenport, IA 52807-2995 - Phone
- (563) 355-2577
- Fax
- (563) 355-4015
- NPI assigned
- May 29, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 001293 | IA | Primary |
| Clinical Psychologist | 103TC0700X | 071008724 | IL |
Addresses
Primary practice location
4455 E 56TH St
Davenport, IA 52807-2995
Mailing address
PO Box 4028
Rock Island, IL 61204-4028
Phone (563) 355-9200
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: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071008724 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432857600000",
"number": "1750760252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4028",
"city": "ROCK ISLAND",
"state": "IL",
"postal_code": "612044028",
"telephone_number": "563-355-9200",
"fax_number": "563-355-3419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4455 E 56TH ST",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528072995",
"telephone_number": "563-355-2577",
"fax_number": "563-355-4015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STROMBERGER",
"first_name": "MELISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-29",
"last_updated": "2015-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IA",
"license": "001293",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071008724",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Davenport, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.