Douglas John Detrick, CADC

Primary specialty

Social WorkerTaxonomy code 104100000X

License

11011 Issued in IA

Practice address

1801 Hickman Rd
Des Moines, IA 50314-1505

Phone

(515) 282-6624

NPI assigned

Oct 26, 2011

Last updated

Oct 26, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Flowstate Health LLCGroup PAC ID 1254718398, 14 clinicians

Des Moines Pastoral Counseling CenterGroup PAC ID 0749272649, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ddetrick269686@uihcdirect.org

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.

• Flowstate Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Des Moines, IA
  • NPI 1114678141
  Medicare reassignment Care Compare group NPD
• Mind and Spirit Counseling Center

  • Mental Health Counselor
  • Urbandale, IA
  • NPI 1578574786
  Medicare reassignment Care Compare group NPD
• Crossroads Behavioral Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Creston, IA
  • NPI 1578531877
  Medicare reassignment NPD
• Way of Harmony Behavioral Health Services, PLLC

  • Clinical Social Worker
  • Las Cruces, NM
  • NPI 1043199912
  NPD Authorized official
• Crossroads Behavioral Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Creston, IA
  • NPI 1053694802
  NPD (past)

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1790061430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 11TH ST",
            "address_2": "#113",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502652118",
            "telephone_number": "515-988-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 HICKMAN RD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503141505",
            "telephone_number": "515-282-6624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETRICK",
        "first_name": "DOUGLAS",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "CADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-26",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "11011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Des Moines River Physicians, LLC
• Des Moines University Osteopathic Medical Center
• Des Moines University Osteopathic Medical Center (Des Moines University Clinic)
• Tara Ann Desocio-Young, RN
• Samantha Jane Detar, OD
• Lauren Devan, LCSW
• Rajan Devan, RPH
• Lynzy Marie Devary, ARNP
• Darrel Devick, DO
• Connor I Devin

• Social Worker in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.