Active NPI
Dustin Daugherty
- Social Worker
- West Des Moines, IA
National Provider Identifier
1396912481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 1200 Valley West Dr
Ste 204
West Des Moines, IA 50266-1902 - Phone
- (515) 868-0444
- Fax
- (515) 225-7546
- NPI assigned
- May 8, 2008
- Last updated
- Nov 20, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
1200 Valley West Dr
Ste 204
West Des Moines, IA 50266-1902
Mailing address
1200 Valley West Dr
Ste 408
West Des Moines, IA 50266-1942
Phone (515) 868-0444
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120411000847 | IA | Practitioner - Clinical Social Worker | 8123289543 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542672000000",
"number": "1396912481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 VALLEY WEST DR",
"address_2": "STE 408",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "502661942",
"telephone_number": "515-868-0444",
"fax_number": "515-225-7546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 VALLEY WEST DR",
"address_2": "STE 204",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "502661902",
"telephone_number": "515-868-0444",
"fax_number": "515-225-7546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAUGHERTY",
"first_name": "DUSTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-08",
"last_updated": "2018-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.