Individual provider Active NPI

Rachel Reis Da Silva

  • Clinical Social Worker
  • Iola, KS
National Provider Identifier
1215290614
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
06060 Issued in KS
Practice address
304 N Jefferson Ave
Iola, KS 66749-2327
Phone
(620) 365-5717
NPI assigned
Jun 20, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 10522843-3501 UT
Clinical Social Worker 1041C0700X ASW 33383
Clinical Social Worker 1041C0700X 06060 KS Primary

Addresses

Primary practice location

304 N Jefferson Ave
Iola, KS 66749-2327

Mailing address

304 N Jefferson Ave
Iola, KS 66749-2327
Phone (620) 365-5717

Other names 1

  • Rachel L Reis Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20230814001540 KS Practitioner - Clinical Social Worker 1759743305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

304 N Jefferson Ave
Iola, KS 66749-2327
Phone (620) 365-5717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06060KSMDClinical Social Worker
10522843-3501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Kansas Mental Health Center CurrentSince Aug 1, 2023 Accepting new patients
Pawnee Mental Health Service, Inc. Past Accepting new patients

Locations

1106 S 9th St
Humboldt, KS 66748
Phone (620) 473-2241

304 N Jefferson Ave
Iola, KS 66749
Phone (620) 365-5717

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": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1215290614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 N JEFFERSON AVE",
            "city": "IOLA",
            "state": "KS",
            "postal_code": "667492327",
            "telephone_number": "620-365-5717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 N JEFFERSON AVE",
            "city": "IOLA",
            "state": "KS",
            "postal_code": "667492327",
            "telephone_number": "620-365-5717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIS DA SILVA",
        "first_name": "RACHEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-20",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "10522843-3501",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "ASW 33383",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "06060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "REIS",
            "middle_name": "L",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Iola, KS

Sources for this page

Verify at the official NPI Registry.