Individual provider Active NPI

Chelyne Jeanette Cunningham-Sullivan, LISW

  • Social Worker
  • West Des Moines, IA
National Provider Identifier
1659541126
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
006960 Issued in IA
Practice address
939 Office Park Rd Ste 103
West Des Moines, IA 50265-2505
Phone
(515) 221-1989
NPI assigned
Mar 11, 2008
Last updated
Dec 3, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 006960 IA Primary

Addresses

Primary practice location

939 Office Park Rd Ste 103
West Des Moines, IA 50265-2505

Mailing address

939 Office Park Rd Ste 103
West Des Moines, IA 50265-2505
Phone (515) 221-1989

Other practice location 1

200 4th Ave W
Grinnell, IA 50112-1833
Phone (641) 236-6137

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20190220002512 IA Practitioner - Clinical Social Worker 8729326566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Iowa, RJ & L Carver College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

939 Office Park Rd
Suite 103
West Des Moines, IA 50265-2505
Phone (515) 221-1989

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Chelyne J. Cunningham Counseling, Inc. CurrentSince Nov 1, 2017 Accepting new patients
Capstone Behavioral Healthcare, Inc PastSince Nov 1, 2021 Accepting new patients
Poweshiek County Mental Health Center Past Accepting new patients

Locations

939 Office Park Rd
Ste 103
West Des Moines, IA 50265
Phone (515) 221-1989

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1659541126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 OFFICE PARK RD STE 103",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502652505",
            "telephone_number": "515-221-1989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 OFFICE PARK RD STE 103",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502652505",
            "telephone_number": "515-221-1989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 4th Ave W",
            "address_purpose": "LOCATION",
            "city": "Grinnell",
            "state": "IA",
            "postal_code": "501121833",
            "country_code": "US",
            "telephone_number": "641-236-6137",
            "fax_number": "641-236-0206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUNNINGHAM-SULLIVAN",
        "first_name": "CHELYNE",
        "middle_name": "JEANETTE",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-11",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "006960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

Verify at the official NPI Registry.