Kelly Rennick O'Berry, LISW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

06475 Issued in IA

Practice address

7755 Office Plaza Dr N
Suite 105
West Des Moines, IA 50266-2339

Phone

(515) 201-0439

NPI assigned

Jul 11, 2012

Last updated

Apr 7, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kelly Ann Rennick Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491523200000",
    "number": "1861757148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7755 OFFICE PLAZA DR N",
            "address_2": "SUITE 105",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502662339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7755 OFFICE PLAZA DR N",
            "address_2": "SUITE 105",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502662339",
            "telephone_number": "515-201-0439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BERRY",
        "first_name": "KELLY",
        "middle_name": "RENNICK",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2017-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "06475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861757148",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "RENNICK",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashley Nupp, LMHC
• Nurse Force Hospice Inc (Nurse Force Hospice)
• Nurturing Hearts Therapy, LLC.
• Frederick S Nuss, M.D.
• McKenzie Nuss, DNP
• Kamryn F O'Brien
• Kathy O'Brien, T-LMHC , CADC
• Michael C O'Brien
• Mollie O'Brien, ARNP
• Bailey O'Donnell, PA-C

• Social Worker in West Des Moines, IA
• Providers in West 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 Apr 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.