Individual provider Active NPI

Patricia L Wilson, LISW

  • Clinical Social Worker
  • Mason City, IA
National Provider Identifier
1396852034
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
02100 Issued in IA
Practice address
1000 4TH St SW
Suite BS
Mason City, IA 50401-2800
Phone
(641) 422-7797
Fax
(641) 422-7516
NPI assigned
Aug 25, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 02100 IA Primary

Addresses

Primary practice location

1000 4TH St SW
Suite BS
Mason City, IA 50401-2800

Mailing address

621 S Illinois Ave
Suite 103
Mason City, IA 50401-5489
Phone (641) 494-3041

Other identifiers 1

IdentifierTypeStateIssuer
44046OtherIAWELLMARK

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
I20100206000057 IA Practitioner - Clinical Social Worker 1951444389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deer Oaks Mental Health Associates PCGroup PAC ID 2264337013, 55 clinicians

Practice addresses (Care Compare)

407 S E Ave
Baxter, IA 50028-1013
Phone (641) 227-3602

Merit-based Incentive Payment System (MIPS)

Final score
91.16 of 100Reported as group
Quality
80.99
Improvement activities
40
Cost
72.05

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02100IAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Services-Iowa Corp Past Accepting new patients
North Iowa Mercy Clinics Past Accepting new patients

Organizations & group practices 3

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396852034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S ILLINOIS AVE",
            "address_2": "SUITE 103",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504015489",
            "telephone_number": "641-494-3041",
            "fax_number": "641-494-3059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 4TH ST SW",
            "address_2": "SUITE BS",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504012800",
            "telephone_number": "641-422-7797",
            "fax_number": "641-422-7516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "PATRICIA",
        "middle_name": "L",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "02100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "44046",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason City, IA

Sources for this page

Verify at the official NPI Registry.