Active NPI
Roderick Love
- Clinical Social Worker
- Jacksonville, FL
National Provider Identifier
1790060671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 4203 Southpoint Blvd.
Jacksonville, FL 32216 - Phone
- (904) 296-1055
- Fax
- (904) 296-1953
- NPI assigned
- Oct 11, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
4203 Southpoint Blvd.
Jacksonville, FL 32216
Mailing address
4203 Southpoint Blvd.
Jacksonville, FL 32216
Phone (904) 296-1055
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| APPLYING FOR NUMBER | Medicaid | FL |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Daniel Memorial, Inc. | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Jacksonville, FL
- NPI 1346205861
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318291200000",
"number": "1790060671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4203 SOUTHPOINT BLVD.",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32216",
"telephone_number": "904-296-1055",
"fax_number": "904-296-1953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4203 SOUTHPOINT BLVD.",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32216",
"telephone_number": "904-296-1055",
"fax_number": "904-296-1953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOVE",
"first_name": "RODERICK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-11",
"last_updated": "2011-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "APPLYING FOR NUMBER",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.