Individual provider Active NPI

Evelyn Lee Conrad, LMSW

  • Clinical Social Worker
  • Leon, IA
National Provider Identifier
1821324641
Registry record updated May 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
06727 Issued in IA
Practice address
302 NE 14TH St
Leon, IA 50144-1206
Phone
(641) 446-2383
Fax
(641) 446-2382
NPI assigned
Oct 29, 2009
Sex
Female
Sole proprietor
No

Organizations & group practices 12

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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinity Health 19 clinicians

Practice addresses (Care Compare)

802 Ackerley St
Lamoni, IA 50140-1544
Phone (641) 784-7911

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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20140414002053 IA Practitioner - Clinical Social Worker 5395977904 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06727IAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Infinity Health CurrentSince Dec 25, 2013 Accepting new patients
Infinity Health CurrentSince Dec 25, 2013 Accepting new patients

Locations

102 N Franklin St
#104
Corydon, IA 50060
Phone (641) 872-1750

302 NE 14th St
Leon, IA 50144
Phone (641) 446-2383

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 06727 IA Primary

Addresses

NPPES NPI Registry

Primary practice location

302 NE 14TH St
Leon, IA 50144-1206

Mailing address

302 NE 14TH St
Leon, IA 50144-1206
Phone (641) 446-2383

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
06727OtherIALICENSE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 9, 2011.

{
    "created_epoch": "1256774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304899200000",
    "number": "1821324641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 NE 14TH ST",
            "city": "LEON",
            "state": "IA",
            "postal_code": "501441206",
            "telephone_number": "641-446-2383",
            "fax_number": "641-446-2382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 NE 14TH ST",
            "city": "LEON",
            "state": "IA",
            "postal_code": "501441206",
            "telephone_number": "641-446-2383",
            "fax_number": "641-446-2382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "EVELYN",
        "middle_name": "LEE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-29",
        "last_updated": "2011-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "06727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "06727",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leon, IA

Sources for this page

Verify at the official NPI Registry.