Individual provider Active NPI

Kathleen Susan McCadam, LCSW

  • Clinical Social Worker
  • Des Moines, IA
National Provider Identifier
1043744675
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
109614 Issued in IA
Practice address
1200 University Ave Ste 120
Des Moines, IA 50314-2355
Phone
(515) 248-1500
Fax
(515) 248-1510
NPI assigned
Apr 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW018990 PA
Clinical Social Worker 1041C0700X 109614 IA Primary

Addresses

Primary practice location

1200 University Ave Ste 120
Des Moines, IA 50314-2355

Mailing address

1200 University Ave Ste 200
Des Moines, IA 50314-2355
Phone (515) 248-1447

Other names 1

  • Kathleen McManus Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20231218001276 IA Practitioner - Clinical Social Worker 0547530404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Health Care IncGroup PAC ID 8426966755, 72 clinicians

Practice addresses (Care Compare)

2353 SE 14TH St
Des Moines, IA 50320-1109
Phone (515) 248-1400

250 Laurel St
Des Moines, IA 50314-3024
Phone (515) 612-9595

3509 E 29TH St
Des Moines, IA 50317-4253
Phone (515) 248-1600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Health Care, Inc. CurrentSince Nov 17, 2023 Accepting new patients
Primary Health Care, Inc. CurrentSince Nov 17, 2023 Accepting new patients

Locations

1200 University Ave
Ste 120
Des Moines, IA 50314
Phone (515) 248-1500

2353 SE 14th St
Des Moines, IA 50320
Phone (515) 248-1400

1200 University Ave
Ste 200
Des Moines, IA 50314
Phone (515) 248-1447

Organizations & group practices 2

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": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1043744675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 UNIVERSITY AVE STE 200",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142355",
            "telephone_number": "515-248-1447",
            "fax_number": "515-248-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 UNIVERSITY AVE STE 120",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142355",
            "telephone_number": "515-248-1500",
            "fax_number": "515-248-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCADAM",
        "first_name": "KATHLEEN",
        "middle_name": "SUSAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-20",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW018990",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "109614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "MCMANUS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.