Carolyn Phillips, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

01733 Issued in IA

Practice address

505 5TH St Ste 520
Sioux City, IA 51101-1506

Phone

(712) 224-2892

Fax

(712) 224-2891

NPI assigned

Jan 5, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IA, SD2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Family Health Care of Siouxland PLCGroup PAC ID 7315839412, 49 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Family Health Care of Siouxland PLC

  • Family Medicine Physician
  • Sioux City, IA
  • NPI 1437170685

  SD

  Medicare reassignment Care Compare group NPD
• Family Health Care of Siouxland LLC

  • Family Medicine Physician
  • Moville, IA
  • NPI 1720278278
  NPD (past)

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1659428076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 5TH ST STE 520",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511011506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 5TH ST STE 520",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511011506",
            "telephone_number": "712-224-2892",
            "fax_number": "712-224-2891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "CAROLYN",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "01733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "38080",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35117800000106704150",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013938",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Destiny Peterson, CNA, HHA
• Paul D Peterson, DO
• Carmon Petters
• Thong Quoc Pham, M.D.
• Sunu John Philip, MD
• Cheyanne Michelle Phillips
• Nathan Phillips, T-LMHC
• Kantima Phisitkul, MD
• Physical Therapy Specialists PC
• Physiotherapy Associates Inc

• Clinical Social Worker in Sioux City, IA
• Providers in Sioux City, 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 Jul 9, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.