Active NPI
Melissa Rose Barnes, LMSW, CAADC
- Clinical Social Worker
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801094879
- Practice address
- 790 Fuller Ave NE
Grand Rapids, MI 49503-1918 - Phone
- (616) 336-3909
- Fax
- (616) 336-8830
- NPI assigned
- Mar 29, 2012
- Last updated
- Feb 14, 2023
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801094879 | MI | |
| Clinical Social Worker | 1041C0700X | 6801094879 | MI | Primary |
Addresses
Primary practice location
790 Fuller Ave NE
Grand Rapids, MI 49503-1918
Mailing address
790 Fuller Ave NE
Grand Rapids, MI 49503-1918
Phone (616) 336-3909
Other practice location 1
4920 Plainfield Ave NE Ste E
Grand Rapids, MI 49525-1010
Phone (616) 951-1677
Other practice location 2
1611 Oak Ave
Muskegon, MI 49442-2468
Phone (231) 767-1921 ext. 7779
Other names 1
- Melissa Rose Killman
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pcerecords.network180.x@direct.mihin.net | Direct |
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
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
790 Fuller Ave NE
Grand Rapids, MI 49503-1918
Phone (616) 825-5412
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801094879 | MI | MD | Clinical Social Worker |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Network 180
- Community/Behavioral Health Agency
- Grand Rapids, MI
- NPI 1588935068
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676332800000",
"number": "1932475340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 FULLER AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495031918",
"telephone_number": "616-336-3909",
"fax_number": "616-336-8830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "790 FULLER AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495031918",
"telephone_number": "616-336-3909",
"fax_number": "616-336-8830"
}
],
"practiceLocations": [
{
"address_1": "4920 Plainfield Ave NE Ste E",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495251010",
"country_code": "US",
"telephone_number": "616-951-1677",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1611 Oak Ave",
"address_purpose": "LOCATION",
"city": "Muskegon",
"state": "MI",
"postal_code": "494422468",
"country_code": "US",
"telephone_number": "231-767-1921 x7779",
"fax_number": "231-767-0527",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BARNES",
"first_name": "MELISSA",
"middle_name": "ROSE",
"credential": "LMSW, CAADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-29",
"last_updated": "2023-02-14",
"certification_date": "2023-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801094879",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801094879",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "pcerecords.network180.x@direct.mihin.net",
"affiliation": "N",
"endpointDescription": "Direct Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "790 Fuller Ave NE",
"city": "Grand Rapids",
"state": "MI",
"country_code": "US",
"postal_code": "495031918",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "MELISSA",
"last_name": "KILLMAN",
"middle_name": "ROSE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.