Katie Roderick, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

112947 Issued in IA

Practice address

320 N Eisenhower Ave
Mason City, IA 50401-1521

Phone

(641) 424-2391

Fax

(641) 424-0783

NPI assigned

Jun 7, 2022

Last updated

Mar 13, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prairie Ridge Integrated Behavioral HealthcareGroup PAC ID 6800169194, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Prairie Ridge Integrated Behavioral Healthcare

  dba Prairie Ridge

  • Substance Abuse Rehabilitation Facility
  • Mason City, IA
  • NPI 1952443632
  Medicare reassignment Care Compare group NPD
• Prairie Ridge Integrated Behavioral Healthcare

  dba Prairie Ridge

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mason City, IA
  • NPI 1801637061
  NPD

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1336878123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 4TH ST SW",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504012800",
            "telephone_number": "641-428-7797",
            "fax_number": "641-428-7416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 N EISENHOWER AVE",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504011521",
            "telephone_number": "641-424-2391",
            "fax_number": "641-424-0783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODERICK",
        "first_name": "KATIE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-07",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "112947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin R Rier, M.D.
• William J Riesen, MD
• Carrissa Riggs, PA
• Brandt Michael Riley, DO
• Nikki Ann Riley, CRNA
• Jezanna Rooney, ARNP
• Roots Nutrition Counseling Inc.
• Sally K Roper, ARNP,FNP
• Jeffrey K Rowe, M.D.
• David A Ruen, MD

• Clinical Social Worker in Mason City, IA
• Providers in Mason City, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.