NPIMap

Organization Active NPI

Covert Action LLC

Doing business as Covert Action

  • Methadone Clinic
  • Des Moines, IA
National Provider Identifier
1700390101
Registry record updated Nov 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
License
1404 Issued in IA
Legal business name
COVERT ACTION LLC
Doing business as
Covert Action
Practice address
1223 Center St Ste 22
Des Moines, IA 50309-1016
Phone
(515) 218-6125
Fax
(515) 265-0845
NPI assigned
Nov 21, 2017
Last updated
Nov 21, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2017

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

Authorized official

Name
Dr. Christopher M Covert, DONPI 1891772968
Title
Program Sponsor
Phone
(515) 778-6608

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X 1404 IA Primary

Addresses

Primary practice location

1223 Center St Ste 22
Des Moines, IA 50309-1016

Mailing address

12734 Lincoln Cir
Clive, IA 50325-2301
Phone (515) 778-6608

Other names 1

  • Covert Action Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191223002240 IA Part B Supplier - Opioid Treatment Program (Otp) 3971937046 Practice locations: Des Moines, IA

National Provider Directory

National Provider Directory

Locations

1223 Center St
Ste 22
Des Moines, IA 50309
Phone (515) 218-6125

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1511222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511222400000",
    "number": "1700390101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12734 LINCOLN CIR",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503252301",
            "telephone_number": "515-778-6608",
            "fax_number": "515-265-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 CENTER ST STE 22",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091016",
            "telephone_number": "515-218-6125",
            "fax_number": "515-265-0845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVERT ACTION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-21",
        "last_updated": "2017-11-21",
        "status": "A",
        "authorized_official_last_name": "COVERT",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PROGRAM SPONSOR",
        "authorized_official_telephone_number": "515-778-6608",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "IA",
            "license": "1404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Covert Action",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2017; 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.