Individual provider Active NPI

Dawn Renee Pappas, LICSW

  • Clinical Social Worker
  • Park Rapids, MN
National Provider Identifier
1043473945
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15228 Issued in MN
Practice address
515 Bridge St
Park Rapids, MN 56470-1210
Phone
(218) 732-7266
NPI assigned
Jul 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 15228 MN Primary

Addresses

Primary practice location

515 Bridge St
Park Rapids, MN 56470-1210

Mailing address

515 Bridge St
Park Rapids, MN 56470-1210
Phone (218) 732-7266

Other identifiers 1

IdentifierTypeStateIssuer
101301714MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040518000256 MN Practitioner - Clinical Social Worker 8527058726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Groupworks LLCGroup PAC ID 5991017402, 2 clinicians

Practice addresses (Care Compare)

1003 Hollinger St
Park Rapids, MN 56470-1300
Phone (218) 366-2636

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15228MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Groupworks LLC Clinical CurrentSince Jun 13, 2013 Accepting new patients
Peterson Medical Clinics, LLC Past Accepting new patients
Upper Mississippi Mental Health Center, Inc Past Accepting new patients

Locations

1003 Hollinger St
Park Rapids, MN 56470
Phone (218) 366-2636

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293494400000",
    "number": "1043473945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 BRIDGE ST",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "564701210",
            "telephone_number": "218-732-7266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 BRIDGE ST",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "564701210",
            "telephone_number": "218-732-7266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPPAS",
        "first_name": "DAWN",
        "middle_name": "RENEE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2010-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "15228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101301714",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Rapids, MN

Sources for this page

Verify at the official NPI Registry.