Individual provider Active NPI

Wagner Rose Larson Silva, MSW, CSW

  • Clinical Social Worker
  • Sioux Falls, SD
National Provider Identifier
1861106627
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6248 Issued in SD
Practice address
2412 S Cliff Ave Ste 200
Sioux Falls, SD 57105-4031
Phone
(605) 322-4079
Fax
(605) 322-4080
NPI assigned
Jan 6, 2023
Last updated
Jan 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6248 SD Primary

Addresses

Primary practice location

2412 S Cliff Ave Ste 200
Sioux Falls, SD 57105-4031

Mailing address

2412 S Cliff Ave Ste 200
Sioux Falls, SD 57105-4031
Phone (605) 322-4079

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20230228000684 SD Practitioner - Clinical Social Worker 5395118079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

2412 S Cliff Ave
Suite 200
Sioux Falls, SD 57105-4031
Phone (605) 322-4079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6248SDMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Jan 3, 2023 Accepting new patients
Avera McKennan CurrentSince Jan 3, 2023 Accepting new patients
Avera McKennan Current Accepting new patients
Luya Counseling, LLC Clinical Current Accepting new patients

Locations

2412 S Cliff Ave
Ste 200
Sioux Falls, SD 57105
Phone (605) 322-4079

3932 S Western Ave
Sioux Falls, SD 57105
Phone (605) 322-6408

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1861106627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 S CLIFF AVE STE 200",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571054031",
            "telephone_number": "605-322-4079",
            "fax_number": "605-322-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 S CLIFF AVE STE 200",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571054031",
            "telephone_number": "605-322-4079",
            "fax_number": "605-322-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON SILVA",
        "first_name": "WAGNER",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "MSW, CSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-06",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SD",
            "license": "6248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.