Active NPI
Rodney Black, MSW
- Clinical Social Worker
- Des Moines, IA
National Provider Identifier
1295981645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 500 E Locust St Ste 126
Des Moines, IA 50309-1955 - Phone
- (888) 948-6789
- Fax
- (877) 345-3501
- NPI assigned
- Aug 15, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 01073 | IA | |
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
500 E Locust St Ste 126
Des Moines, IA 50309-1955
Mailing address
1 Kalisa Way Ste 101
Paramus, NJ 07652-3508
Phone (888) 948-6789
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01073 | IA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alegent Health Community Memorial Hospital of Missouri Valley, Iowa | Past | Accepting new patients | |
| West Iowa Community Mental Health Center | Past | Accepting new patients |
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.
-
- Rural Health Clinic/Center
- Oakland, IA
- NPI 1366063794
-
- Mental Health Counselor
- Denison, IA
- NPI 1609972389
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664236800000",
"number": "1295981645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 KALISA WAY STE 101",
"city": "PARAMUS",
"state": "NJ",
"postal_code": "076523508",
"telephone_number": "888-948-6789",
"fax_number": "877-345-3501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 E LOCUST ST STE 126",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503091955",
"telephone_number": "888-948-6789",
"fax_number": "877-345-3501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "RODNEY",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-15",
"last_updated": "2022-09-27",
"certification_date": "2022-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IA",
"license": "01073",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_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 Sep 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.