Susan Langewisch Kivisto

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

007507 Issued in IA

Practice address

1441 W Central Park Ave
Davenport, IA 52804-1707

Phone

(563) 383-1900

NPI assigned

Feb 5, 2018

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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 and National Provider Directory roles.

• Vera French Community Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Davenport, IA
  • NPI 1245291129
  Medicare reassignment NPD
• Vera French Community Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bettendorf, IA
  • NPI 1568239978
  NPD

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

{
    "created_epoch": "1517788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517788800000",
    "number": "1477052405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 W CENTRAL PARK AVE",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528041707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 W CENTRAL PARK AVE",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528041707",
            "telephone_number": "563-383-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIVISTO",
        "first_name": "SUSAN",
        "middle_name": "LANGEWISCH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-05",
        "last_updated": "2018-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "007507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "007507",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tara M Kinney, CRNA
• Lynette Kirk, LISW
• Chelsie Kirschbaum
• Jacqueline Elizabeth Kitchen, M.D.
• Eric Kitzmann, O.D.
• Kizmit LLC
• Kathryn Louise Klauer, H.I.S.
• Tandem Elysia Klauer, REGISTERED NURSE
• Macey Kathryn Kleitsch
• Anne Klimek, LMSW

• Clinical Social Worker in Davenport, IA
• Providers in Davenport, 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 Feb 5, 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.

Verify at the official NPI Registry.