Individual provider Active NPI

Denise Lauren Kelley Edwards, LISW

  • Social Worker
  • West Des Moines, IA
National Provider Identifier
1730615881
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
086198 Issued in IA
Practice address
5550 Wild Rose LN Ste 400
West Des Moines, IA 50266-5351
Phone
(515) 322-7986
NPI assigned
May 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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 086198 IA Primary

Addresses

Primary practice location

5550 Wild Rose LN Ste 400
West Des Moines, IA 50266-5351

Mailing address

5465 Mills Civic Pkwy Ste 3319
West Des Moines, IA 50266-5318
Phone (515) 322-7986

Other names 1

  • Denise L. Edwards Former name

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
I20170522000164 IA Practitioner - Clinical Social Worker 7315214426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5465 Mills Civic Pkwy
Unit 319
West Des Moines, IA 50266-5326
Phone (515) 322-7986

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
086198IAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Optimae Lifeservices, Inc, CurrentSince Dec 1, 2019 Accepting new patients
Optimae Lifeservices,Inc. Current Accepting new patients
Nurse in the House, Inc. Past Accepting new patients

Locations

2201 W Jefferson Ave
Fairfield, IA 52556
Phone (641) 472-1684

301 W Burlington Ave
Fairfield, IA 52556
Phone (641) 472-1684

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1730615881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5465 MILLS CIVIC PKWY STE 3319",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665318",
            "telephone_number": "515-322-7986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5550 WILD ROSE LN STE 400",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665351",
            "telephone_number": "515-322-7986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY EDWARDS",
        "first_name": "DENISE",
        "middle_name": "LAUREN",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "086198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENISE",
            "last_name": "EDWARDS",
            "middle_name": "L.",
            "credential": "LISW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Des Moines, IA

Sources for this page

Verify at the official NPI Registry.