Individual provider Active NPI

Lee A Nelson, LCSW

  • Clinical Social Worker
  • Independence, MO
National Provider Identifier
1497939094
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004429 Issued in MO
Practice address
3031 M 291 Frontage Rd
Independence, MO 64057-2334
Phone
(816) 373-9240
NPI assigned
Dec 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

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 004429 MO Primary

Addresses

Primary practice location

3031 M 291 Frontage Rd
Independence, MO 64057-2334

Mailing address

3031 M 291 Frontage Rd
Independence, MO 64057-2334
Phone (816) 373-9240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20080523000342 MO Practitioner - Clinical Social Worker 1153490628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Diakonos IncGroup PAC ID 1658323209, 6 clinicians

Practice addresses (Care Compare)

4200 Little Blue Pkwy
Suite 360
Independence, MO 64057-8317
Phone (816) 373-9240

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004429MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Diakonos Inc Clinical CurrentSince May 9, 2008 Accepting new patients
Brian a Fidler Clinical CurrentSince Sep 26, 2013 Accepting new patients

Locations

4200 Little Blue Pkwy
Independence, MO 64057
Phone (816) 353-2700

4200 Little Blue Pkwy
Ste 360
Independence, MO 64057
Phone (816) 373-9240

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198022400000",
    "number": "1497939094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 M 291 FRONTAGE RD",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572334",
            "telephone_number": "816-373-9240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 M 291 FRONTAGE RD",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572334",
            "telephone_number": "816-373-9240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "LEE",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-19",
        "last_updated": "2007-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "004429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.