Individual provider Active NPI

Daniel Pledgejohnson

  • Mental Health Counselor
  • Cedar Rapids, IA
National Provider Identifier
1902487630
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
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, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1568058410MedicaidIA

Electronic endpoints 1

TypeEndpointUseAffiliation
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

OrganizationSpecialtyStatusNew patients
Children of Promise Mentoring Program Mental Health CurrentSince Feb 19, 2023 Accepting new patients
Children of Promise Mentoring Program Mental Health CurrentSince Apr 20, 2021 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.

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.

Verify at the official NPI Registry.