Organization Active NPI

Her Support LLC

  • Social Worker
  • West Des Moines, IA
National Provider Identifier
1245795863
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
HER SUPPORT LLC
Practice address
5550 Wild Rose LN Ste 400
West Des Moines, IA 50266-5351
Phone
(515) 322-7986
NPI assigned
Feb 7, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Authorized official

Name
Denise Edwards
Title
Owner
Phone
(630) 405-9336

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X Primary

Addresses

Primary practice location

5550 Wild Rose LN Ste 400
West Des Moines, IA 50266-5351

Mailing address

5465 Mills Civic Pkwy Ste 3319
West Des Moines, IA 50266-5318
Phone (515) 322-7986

Other identifiers 1

IdentifierTypeStateIssuer
104100000XOtherIATAXONOMY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201020000515 IA Part B Supplier - Clinic/Group Practice 7214357946 Receives reassigned benefits from 1 practitioner
Practice locations: West Des Moines, IA

National Provider Directory

National Provider Directory

Locations

318 5th St
West Des Moines, IA 50265
Phone (515) 222-3660

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1549497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1245795863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5465 MILLS CIVIC PKWY STE 3319",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665318",
            "telephone_number": "515-322-7986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5550 WILD ROSE LN STE 400",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665351",
            "telephone_number": "515-322-7986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HER SUPPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-07",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-405-9336"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "104100000X",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.