Organization Active NPI

Myob LLC

  • Clinical Social Worker
  • Des Moines, IA
National Provider Identifier
1265319362
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MYOB LLC
Practice address
2323 Grand Ave Ste 203
Des Moines, IA 50312-5381
Phone
(515) 412-0240
Fax
(515) 400-1350
NPI assigned
Aug 19, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Authorized official

Name
Jen Wollum
Title
Billing
Phone
(712) 363-0917

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

2323 Grand Ave Ste 203
Des Moines, IA 50312-5381

Mailing address

874 41St St
Des Moines, IA 50312-2610
Phone (515) 412-0240

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260504007514 IA Part B Supplier - Clinic/Group Practice 6103394572 Receives reassigned benefits from 1 practitioner
Practice locations: Des Moines, IA

National Provider Directory

National Provider Directory

Locations

2323 Grand Ave
Ste 203
Des Moines, IA 50312
Phone (515) 412-0240

2323 Grand Ave
Ste 145
Des Moines, IA 50312

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": "1755561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778025600000",
    "number": "1265319362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "874 41ST ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503122610",
            "telephone_number": "515-412-0240",
            "fax_number": "515-400-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 GRAND AVE STE 203",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503125381",
            "telephone_number": "515-412-0240",
            "fax_number": "515-400-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYOB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-19",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A",
        "authorized_official_last_name": "WOLLUM",
        "authorized_official_first_name": "JEN",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "712-363-0917"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; 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.