Chris C Carr, LISW
Individual provider Active NPI Clinical Social Worker · Cherokee, IA
NPI 1679657803 · NPPES record last updated Feb 7, 2008
Key facts
- NPI
- 1679657803
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 04697 (IA)
- Practice address
- 215 N 2ND St
Cherokee, IA 51012-1833 - Phone
- (712) 225-2811
- NPI assigned
- Oct 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Rowan University School of Osteopathic Medicine, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- United Community Health Center Inc
Practice addresses (Care Compare)
715 W Milwaukee Ave
Storm Lake, IA 50588-1564
Phone 71221301091106
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050323000687 | IA | Practitioner - Clinical Social Worker | 1658327697 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04697 | IA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Community Health Center Inc. | Current |
Accepting new patients | |
| Plains Area Mental Health, Inc. | Past |
Accepting new patients | |
| Plains Area Mental Health, Inc. | Past | Accepting new patients |
Locations
715 W Milwaukee Ave
Storm Lake, IA 50588
Phone (712) 213-0109
Interoperability endpoints
- chris.carr.1@20248.direct.athenahealth.com
- https://fhir4.healow.com/fhir/r4/IGGHAA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 04697 | IA | Yes |
Addresses
Primary practice location
215 N 2ND St
Cherokee, IA 51012-1833
Mailing address
PO Box 822
215 North 2ND St.
Cherokee, IA 51012-0822
Phone (712) 225-2811
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32056 | Other | IA | BC/BS |
Other providers in Cherokee, IA
- Care Initiatives
- Careage Hills
- Careage Home Care LLC
- Careage Management LLC
- Samantha Carpenter
- Carrie Stoelting OD PC
- Cassady Rider DDS PLC
- Cherokee Care LLC
- Cherokee Community School District
- Cherokee County Case Management
All providers in Cherokee, IA · Clinical Social Worker in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 7, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.