Organization Active NPI

Susannah Shell-Phillips PLLC

  • Clinical Social Worker
  • Sioux City, IA
National Provider Identifier
1609590488
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SUSANNAH SHELL-PHILLIPS PLLC
Practice address
1101 4TH St FL 2
Sioux City, IA 51101-1952
Phone
(712) 490-0006
NPI assigned
Sep 27, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Authorized official

Name
Susan Romanik
Title
Office Billing Manager
Phone
(402) 496-9966

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1101 4TH St FL 2
Sioux City, IA 51101-1952

Mailing address

1515 N 129TH St
Omaha, NE 68154-1079
Phone (402) 496-9966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221208001828 IA Part B Supplier - Clinic/Group Practice 8123497443 Receives reassigned benefits from 1 practitioner
Practice locations: Sioux City, IA

National Provider Directory

National Provider Directory

Locations

1101 4th St
Fl 2
Sioux City, IA 51101
Phone (323) 366-0993

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664236800000",
    "number": "1609590488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 N 129TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681541079",
            "telephone_number": "402-496-9966",
            "fax_number": "402-496-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 4TH ST FL 2",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511011952",
            "telephone_number": "712-490-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSANNAH SHELL-PHILLIPS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-27",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A",
        "authorized_official_last_name": "ROMANIK",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OFFICE BILLING MANAGER",
        "authorized_official_telephone_number": "402-496-9966"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.