Individual provider Active NPI

Kellie Colleen Corkery, LMSW

  • Social Worker
  • Hiawatha, IA
National Provider Identifier
1437522869
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
007513 Issued in IA
Practice address
1340 Blairs Ferry Rd Unit a
Hiawatha, IA 52233-1900
Phone
(319) 398-6694
NPI assigned
Nov 6, 2015
Last updated
Dec 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 007513 IA Primary

Addresses

Primary practice location

1340 Blairs Ferry Rd Unit a
Hiawatha, IA 52233-1900

Mailing address

1340 Blairs Ferry Rd Unit a
Hiawatha, IA 52233-1900
Phone (319) 398-6694

Other identifiers 1

IdentifierTypeStateIssuer
104339000MedicaidIA

Other names 1

  • Kellie Colleen Alexander Former name

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
I20180817002022 IA Practitioner - Clinical Social Worker 9830448232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Medical CenterGroup PAC ID 4183535271, 295 clinicians

Practice addresses (Care Compare)

1340 Blairs Ferry Rd
Unit a
Hiawatha, IA 52233-1900
Phone (319) 398-6575

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007513IAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Center CurrentSince Aug 1, 2018 Accepting new patients
Mercy Medical Center Social Worker CurrentSince Aug 1, 2018 Accepting new patients
Horizons, a Family Service Alliance PastSince Jul 1, 2005 Accepting new patients
Horizons, a Family Service Alliance Past Accepting new patients

Locations

701 10th St SE
Cedar Rapids, IA 52403
Phone (319) 398-6011

777 76th Avenue Dr SW
Ste 500
Cedar Rapids, IA 52404
Phone (319) 558-0350

1340 Blairs Ferry Rd
Unit A
Hiawatha, IA 52233
Phone (319) 398-6694

Organizations & group practices 4

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": "1446768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1437522869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 BLAIRS FERRY RD UNIT A",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "522331900",
            "telephone_number": "319-398-6694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 BLAIRS FERRY RD UNIT A",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "522331900",
            "telephone_number": "319-398-6694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORKERY",
        "first_name": "KELLIE",
        "middle_name": "COLLEEN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-06",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "007513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104339000",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLIE",
            "last_name": "ALEXANDER",
            "middle_name": "COLLEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hiawatha, IA

Sources for this page

Verify at the official NPI Registry.