Individual provider Active NPI

Randalyn Parker, LMSW

  • Clinical Social Worker
  • Des Moines, IA
National Provider Identifier
1265849673
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
072993 Issued in IA
Practice address
1111 University Ave
Des Moines, IA 50314-2329
Phone
(515) 288-9181
Fax
(515) 288-9109
NPI assigned
Jul 17, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 072993 IA Primary

Addresses

Primary practice location

1111 University Ave
Des Moines, IA 50314-2329

Mailing address

115 W McLane St
Osceola, IA 50213-1419
Phone (515) 288-1981

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20191023003606 IA Practitioner - Clinical Social Worker 8426380411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Childserve Clinic IncGroup PAC ID 4082034913, 3 clinicians

Practice addresses (Care Compare)

5406 Merle Hay Rd
Johnston, IA 50131-1209
Phone (515) 727-8750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
072993IAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Childserve Clinic Inc Clinical CurrentSince Feb 9, 2021 Accepting new patients

Locations

5406 Merle Hay Rd
Johnston, IA 50131
Phone (515) 727-8750

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": "1405555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405555200000",
    "number": "1265849673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W MCLANE ST",
            "city": "OSCEOLA",
            "state": "IA",
            "postal_code": "502131419",
            "telephone_number": "515-288-1981",
            "fax_number": "515-288-9109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 UNIVERSITY AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142329",
            "telephone_number": "515-288-9181",
            "fax_number": "515-288-9109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "RANDALYN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-17",
        "last_updated": "2014-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "072993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.