Active NPI
Mervin M. Carnahan, MSW
- Social Worker
- Waterloo, IA
National Provider Identifier
1407884331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 981
- Practice address
- 2750 Saint Francis Dr
Waterloo, IA 50702-5644 - Phone
- (319) 272-8922
- Fax
- (319) 272-8929
- NPI assigned
- Jun 29, 2006
- 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 | 981 | IA | Primary |
Addresses
Primary practice location
2750 Saint Francis Dr
Waterloo, IA 50702-5644
Mailing address
2101 Kimball Ave
LL14
Waterloo, IA 50702-5063
Phone (319) 272-1590
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 |
|---|---|---|---|
| 981 | IA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184284800000",
"number": "1407884331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 KIMBALL AVE",
"address_2": "LL14",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507025063",
"telephone_number": "319-272-1590",
"fax_number": "319-272-1535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2750 SAINT FRANCIS DR",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507025644",
"telephone_number": "319-272-8922",
"fax_number": "319-272-8929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARNAHAN",
"first_name": "MERVIN",
"middle_name": "M.",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2007-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IA",
"license": "981",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterloo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.