Individual provider Active NPI

Pamela Nelson-Grotrian, LISW

  • Clinical Social Worker
  • Des Moines, IA
National Provider Identifier
1326180449
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
03135 Issued in IA
Practice address
2704 Sheridan Ave
Des Moines, IA 50310-5601
Phone
(515) 272-5075
NPI assigned
Feb 13, 2007
Last updated
Oct 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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 03135 IA Primary

Addresses

Primary practice location

2704 Sheridan Ave
Des Moines, IA 50310-5601

Mailing address

2704 Sheridan Ave
Des Moines, IA 50310-5601
Phone (515) 279-2892

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
I20050420000908 IA Practitioner - Clinical Social Worker 6901844919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2704 Sheridan Ave
Des Moines, IA 50310-5601
Phone (515) 272-5075

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aging Pathways, LLC Clinical CurrentSince Oct 12, 2021 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1326180449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 SHERIDAN AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503105601",
            "telephone_number": "515-279-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 SHERIDAN AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503105601",
            "telephone_number": "515-272-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON-GROTRIAN",
        "first_name": "PAMELA",
        "name_prefix": "Ms.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "03135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.