Individual provider Active NPI

Everett Thomas Asby, LMSW

  • Social Worker
  • Cedar Rapids, IA
National Provider Identifier
1881966836
Registry record updated Feb 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
007616 Issued in IA
Practice address
1953 1St Ave SE
Cedar Rapids, IA 52402-5328
Phone
(319) 364-1953
NPI assigned
Feb 7, 2012
Last updated
Feb 7, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2012

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 007616 IA Primary

Addresses

Primary practice location

1953 1St Ave SE
Cedar Rapids, IA 52402-5328

Mailing address

1301 Memorial Dr SE
Cedar Rapids, IA 52403-3545
Phone (319) 533-8067

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20170410002446 IL Practitioner - Clinical Social Worker 8022394832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southpark Psychology LTDGroup PAC ID 8527203090, 21 clinicians

Practice addresses (Care Compare)

2100 52ND Ave
Moline, IL 61265-6366
Phone (309) 797-2900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007616IAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southpark Psychology LTD CurrentSince May 1, 2017 Accepting new patients
Life Connection, L.C. Social Worker Past Accepting new patients

Locations

2100 52nd Ave
Moline, IL 61265
Phone (309) 797-2900

Organizations & group practices 2

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": "1328572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328572800000",
    "number": "1881966836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 MEMORIAL DR SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524033545",
            "telephone_number": "319-533-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1953 1ST AVE SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025328",
            "telephone_number": "319-364-1953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASBY",
        "first_name": "EVERETT",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-07",
        "last_updated": "2012-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "007616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.