Individual provider Active NPI

Amanda Myer

  • Clinical Social Worker
  • Kansas City, MO
National Provider Identifier
1164979647
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2020028483 Issued in MO
Practice address
1911 E 23Rd St
Kansas City, MO 64127-3701
Phone
(816) 241-3448
NPI assigned
Sep 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X 2020028483 MO Primary

Addresses

Primary practice location

1911 E 23Rd St
Kansas City, MO 64127-3701

Mailing address

5512 Rockhill Rd
Kansas City, MO 64110-2740
Phone (573) 275-3447

Other practice location 1

11059 E. Bethany Drive
Aurora, CO 80014
Phone (303) 617-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221014000671 MO Practitioner - Clinical Social Worker 4981070091 Reassigns benefits to 1 organization
I20221024001540 CO Practitioner - Clinical Social Worker 4981070091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

4625 Lindell Blvd
Suite 200And300
Saint Louis, MO 63108-3725
Phone (866) 630-0966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2020028483MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Oct 11, 2022 Accepting new patients

Locations

720 S Colorado Blvd
Ph N
Glendale, CO 80246
Phone (833) 988-0589

107 W 9th St
Fl 2
Kansas City, MO 64105
Phone (505) 382-2776

4625 Lindell Blvd
Ste 200300
Saint Louis, MO 63108
Phone (314) 396-7900

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1164979647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5512 ROCKHILL RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641102740",
            "telephone_number": "573-275-3447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 E 23RD ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641273701",
            "telephone_number": "816-241-3448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11059 E. Bethany Drive",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "80014",
            "country_code": "US",
            "telephone_number": "303-617-2300",
            "fax_number": "303-617-2365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYER",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2020028483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.