Michael Rae Davis, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

02700 Issued in IA

Practice address

1221 S Gear Ave
West Burlington, IA 52655-1681

Phone

(319) 524-3560

Fax

(319) 865-3110

NPI assigned

Aug 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Electronic endpoints 1

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

Specialty

Clinical Social Worker

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Hillcrest Family ServicesGroup PAC ID 1557274743, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.davis@direct.greatriverhealth.org

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.

• Hillcrest Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Washington, IA
  • NPI 1023232824

  IA

  Medicare reassignment Care Compare group NPD
• Hillcrest Family Services

  • Community/Behavioral Health Agency
  • Mt Pleasant, IA
  • NPI 1245652577
  NPD
• Hillcrest Family Services

  • Primary Care Clinic/Center
  • Dubuque, IA
  • NPI 1497354773
  NPD
• Insight Partnership Group

  • Community/Behavioral Health Agency
  • Mt Pleasant, IA
  • NPI 1124395660
  NPD (past)
• Nurse in the House, Inc.

  • Home Health Agency
  • Des Moines, IA
  • NPI 1598196040
  NPD (past)
• Optimae Lifeservices, Inc,

  • Community/Behavioral Health Agency
  • Fairfield, IA
  • NPI 1174520084

  Clinical

  NPD (past)
• Southeast Iowa Regional Medical Center, Inc.

  • Community Based Hospice Care Agency
  • West Burlington, IA
  • NPI 1053315002
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1144239641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2416 340TH ST",
            "city": "KEOKUK",
            "state": "IA",
            "postal_code": "526329539",
            "telephone_number": "319-524-3560",
            "fax_number": "319-865-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 S GEAR AVE",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551681",
            "telephone_number": "319-524-3560",
            "fax_number": "319-865-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MICHAEL",
        "middle_name": "RAE",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "02700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "800013924",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "59126",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0268474",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS",
            "identifier": "11098",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "463086",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.davis@direct.greatriverhealth.org",
            "affiliation": "N",
            "endpointDescription": "Great River Mental Health Care, 1221 S. Gear Ave, West Burlington, IA 52655",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1221 S Gear Ave",
            "city": "West Burlington",
            "state": "IA",
            "country_code": "US",
            "postal_code": "526551681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Paula J Ean Curran, ARNP
• Marsha Dace, LMHC
• Natalia Dacin
• William S Daft, M.D.
• Rachel Ann David, MPH, RDN, LD
• Molly Davis, CNM
• William R Daws, M.D.
• Jennifer Bagwell De la Rosa, DO
• Evangeline De Sagun, MD
• Ryan Deets

• All providers in West Burlington, IA
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.

Verify at the official NPI Registry.