Active NPI
Daniel Pledgejohnson
- Mental Health Counselor
- Cedar Rapids, IA
National Provider Identifier
1902487630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1030 5TH Ave SE Ste 1200
Cedar Rapids, IA 52403-2428 - Phone
- (319) 529-1543
- Fax
- (833) 667-0184
- NPI assigned
- Apr 15, 2021
- Last updated
- Apr 15, 2021
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | IA | Primary |
Addresses
Primary practice location
1030 5TH Ave SE Ste 1200
Cedar Rapids, IA 52403-2428
Mailing address
1143 Longfellow Ave
Waterloo, IA 50703-1720
Phone (319) 529-1543
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568058410 | Medicaid | IA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | KASA | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children of Promise Mentoring Program | Mental Health | Current | Accepting new patients |
| Children of Promise Mentoring Program | Mental Health | Current | Accepting new patients |
Locations
1030 5th Ave SE
Ste 1200
Cedar Rapids, IA 52403
Phone (319) 529-1543
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.
-
- Mental Health Counselor
- Cedar Rapids, IA
- NPI 1265130587
-
- Mental Health Counselor
- Cedar Rapids, IA
- NPI 1568058410
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618444800000",
"number": "1902487630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1143 LONGFELLOW AVE",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507031720",
"telephone_number": "319-529-1543",
"fax_number": "833-667-0184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030 5TH AVE SE STE 1200",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524032428",
"telephone_number": "319-529-1543",
"fax_number": "833-667-0184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLEDGEJOHNSON",
"first_name": "DANIEL",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-15",
"last_updated": "2021-04-15",
"certification_date": "2021-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1568058410",
"state": "IA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "KASA",
"affiliation": "N",
"endpointDescription": "Secure therapy notes",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1030 5th Ave SE Ste 1200",
"city": "Cedar Rapids",
"state": "IA",
"country_code": "US",
"postal_code": "524032428",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Cedar Rapids, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.