Individual provider Active NPI

Alexis Lively

  • Clinical Social Worker
  • Des Moines, IA
National Provider Identifier
1114694650
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
107340 Issued in IA
Practice address
808 5TH Ave
Des Moines, IA 50309-1307
Phone
(515) 244-2267
NPI assigned
Aug 24, 2021
Last updated
Aug 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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 107340 IA Primary

Addresses

Primary practice location

808 5TH Ave
Des Moines, IA 50309-1307

Mailing address

808 5TH Ave
Des Moines, IA 50309-1307
Phone (515) 244-2267

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
I20240125004000 IA Practitioner - Clinical Social Worker 3173976180 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Post Acute Care PLLC Clinical CurrentSince Jan 1, 2024 Accepting new patients
Daybreak Counseling Inc. Past Accepting new patients

Locations

233 University Ave
Des Moines, IA 50314
Phone (515) 284-1280

2001 Kennedy St
Granger, IA 50109
Phone (515) 999-2588

204 N Keokuk Washington Rd
Keota, IA 52248
Phone (641) 636-3400

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1114694650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 5TH AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091307",
            "telephone_number": "515-244-2267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 5TH AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091307",
            "telephone_number": "515-244-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVELY",
        "first_name": "ALEXIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "107340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.