Active NPI
Brenda Medders, MSW
- Social Worker
- Jacksonville, FL
National Provider Identifier
1801915202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 11728 Aaron Rd
Jacksonville, FL 32218-3929 - Phone
- (904) 757-4805
- NPI assigned
- Mar 28, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
11728 Aaron Rd
Jacksonville, FL 32218-3929
Mailing address
11728 Aaron Rd
Jacksonville, FL 32218-3929
Phone (904) 757-4805
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801915202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11728 AARON RD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322183929",
"telephone_number": "904-757-4805",
"fax_number": "904-751-3805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11728 AARON RD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322183929",
"telephone_number": "904-757-4805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDDERS",
"first_name": "BRENDA",
"name_prefix": "Ms.",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.