Individual provider Active NPI

Anna Larue Splady, LICSW

  • Clinical Social Worker
  • Duluth, MN
National Provider Identifier
1609109255
Registry record updated Aug 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
19887 Issued in MN
Practice address
205 W 2ND St
Ste 421
Duluth, MN 55802-1928
Phone
(218) 302-5440
Fax
(218) 302-5442
NPI assigned
Sep 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2019

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 19887 MN Primary

Addresses

Primary practice location

205 W 2ND St
Ste 421
Duluth, MN 55802-1928

Mailing address

205 W 2ND St
Ste 421
Duluth, MN 55802-1928
Phone (218) 302-5440

Other practice location 1

1406 E 2nd St
Duluth, MN 55805-2378
Phone (218) 624-5683

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20120106000660 MN Practitioner - Clinical Social Worker 7911173224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

205 W 2ND St
Suite 421
Duluth, MN 55802-1920
Phone (218) 302-5440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19887MNMDClinical Social Worker

Organizations & group practices 1

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": "1252972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1609109255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W 2ND ST",
            "address_2": "STE 421",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021928",
            "telephone_number": "218-302-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W 2ND ST",
            "address_2": "STE 421",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021928",
            "telephone_number": "218-302-5440",
            "fax_number": "218-302-5442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1406 E 2nd St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558052378",
            "country_code": "US",
            "telephone_number": "218-624-5683",
            "fax_number": "218-624-5736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPLADY",
        "first_name": "ANNA",
        "middle_name": "LARUE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-15",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.