Active NPI
Trevor Dismore
- Clinical Social Worker
- Decorah, IA
National Provider Identifier
1891144119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 081367
- Practice address
- 905 Montgomery St
Decorah, IA 52101-2325 - Phone
- (563) 382-3649
- Fax
- (563) 382-8183
- NPI assigned
- Jun 7, 2016
- Last updated
- Jun 7, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 081367 | IA | Primary |
Addresses
Primary practice location
905 Montgomery St
Decorah, IA 52101-2325
Mailing address
905 Montgomery St
Decorah, IA 52101-2325
Phone (563) 382-3649
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4615 Chadwick Rd
Suite 2
Cedar Falls, IA 50613-8091
Phone (319) 255-5660
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Candeo Counseling Center Inc | Current | Accepting new patients | |
| United Community Services, Inc. | Past | Accepting new patients |
Locations
4615 Chadwick Rd
Ste 2
Cedar Falls, IA 50613
Phone (319) 225-5660
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.
-
- Counselor
- Cedar Falls, IA
- NPI 1720684665
-
- Point of Service
- West Des Moines, IA
- NPI 1609998137
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465257600000",
"number": "1891144119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905 MONTGOMERY ST",
"city": "DECORAH",
"state": "IA",
"postal_code": "521012325",
"telephone_number": "563-382-3649",
"fax_number": "563-382-8183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "905 MONTGOMERY ST",
"city": "DECORAH",
"state": "IA",
"postal_code": "521012325",
"telephone_number": "563-382-3649",
"fax_number": "563-382-8183"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DISMORE",
"first_name": "TREVOR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-07",
"last_updated": "2016-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IA",
"license": "081367",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decorah, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; 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.