Individual provider Active NPI

Karla A Mracek-Knight, LISW, RD

  • Clinical Social Worker
  • Des Moines, IA
National Provider Identifier
1669626396
Registry record updated Dec 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
082963 Issued in IA
Practice address
400 E Court Ave Ste 236
Des Moines, IA 50309-2023
Phone
(515) 650-1812
NPI assigned
Nov 7, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 001841 IA
Clinical Social Worker 1041C0700X 082963 IA Primary

Addresses

Primary practice location

400 E Court Ave Ste 236
Des Moines, IA 50309-2023

Mailing address

4505 29TH St
Des Moines, IA 50310-5824
Phone (563) 380-4118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Oct 1, 2026 through Oct 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
082963IAMDClinical Social Worker
001841IAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1226016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1669626396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 29TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503105824",
            "telephone_number": "563-380-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E COURT AVE STE 236",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503092023",
            "telephone_number": "515-650-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MRACEK-KNIGHT",
        "first_name": "KARLA",
        "middle_name": "A",
        "credential": "LISW, RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-07",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IA",
            "license": "001841",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "082963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.