Active NPI
Amanda Jane Duddleson, MSW, LSW
- Social Worker
- South Bend, IN
National Provider Identifier
1841287950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 415 E Madison St
South Bend, IN 46617-2322 - Phone
- (574) 280-1234
- Fax
- (574) 280-4605
- NPI assigned
- Oct 4, 2005
- Last updated
- Mar 15, 2012
- 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 | NU | Primary |
Addresses
Primary practice location
415 E Madison St
South Bend, IN 46617-2322
Mailing address
415 E Madison St
P.O. Box 1240
South Bend, IN 46617-2322
Phone (574) 280-1234
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331769600000",
"number": "1841287950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 E MADISON ST",
"address_2": "P.O. BOX 1240",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466172322",
"telephone_number": "574-280-1234",
"fax_number": "574-280-4605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 E MADISON ST",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466172322",
"telephone_number": "574-280-1234",
"fax_number": "574-280-4605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUDDLESON",
"first_name": "AMANDA",
"middle_name": "JANE",
"name_prefix": "Mrs.",
"credential": "MSW, LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-04",
"last_updated": "2012-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.