Individual provider Active NPI

Patrick J McMannus, LISW

  • Clinical Social Worker
  • Coralville, IA
National Provider Identifier
1477107555
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
072187 Issued in IA
Practice address
2869 Spring Rose Cir Apt 105
Coralville, IA 52241-0079
Phone
(515) 227-1718
NPI assigned
Jul 28, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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 072187 IA Primary

Addresses

Primary practice location

2869 Spring Rose Cir Apt 105
Coralville, IA 52241-0079

Mailing address

601 Highway 6 W
Iowa City, IA 52246-2209
Phone (515) 227-1718

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
072187IAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1564272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1477107555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 HIGHWAY 6 W",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522462209",
            "telephone_number": "515-227-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2869 SPRING ROSE CIR APT 105",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522410079",
            "telephone_number": "515-227-1718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMANNUS",
        "first_name": "PATRICK",
        "middle_name": "J",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-28",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "072187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coralville, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.