Individual provider Active NPI

Amanda Briggs Davis, CSW-PIP

  • Clinical Social Worker
  • Sioux Falls, SD
National Provider Identifier
1922396027
Registry record updated Jul 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2912 Issued in SD
Practice address
2333 W 57TH St Ste 103
Sioux Falls, SD 57108-5054
Phone
(605) 271-5640
NPI assigned
Jul 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2912 SD Primary

Addresses

Primary practice location

2333 W 57TH St Ste 103
Sioux Falls, SD 57108-5054

Mailing address

2333 W 57TH St Ste 103
Sioux Falls, SD 57108-5054
Phone (605) 271-5640

Other identifiers 1

IdentifierTypeStateIssuer
192 239 6027MedicaidSD

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL https://www.wellnesscollectivesd.com
CONNECT URL www.wellnesscollectivesd.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20111021000411 SD Practitioner - Clinical Social Worker 6800069600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Wellness CollectiveGroup PAC ID 1951722834, 9 clinicians

Practice addresses (Care Compare)

2333 W 57TH St
Suite 103
Sioux Falls, SD 57108-5054
Phone (605) 271-5640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Wellness Collective LLC Clinical CurrentSince May 13, 2020 Accepting new patients

Locations

2333 W 57th St
Ste 103
Sioux Falls, SD 57108
Phone (605) 271-5640

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625875200000",
    "number": "1922396027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 W 57TH ST STE 103",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571085054",
            "telephone_number": "605-271-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 W 57TH ST STE 103",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571085054",
            "telephone_number": "605-271-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "AMANDA",
        "middle_name": "BRIGGS",
        "credential": "CSW-PIP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-11",
        "last_updated": "2021-07-10",
        "certification_date": "2021-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SD",
            "license": "2912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192 239 6027",
            "state": "SD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.wellnesscollectivesd.com",
            "affiliation": "N",
            "address_1": "2333 W 57th St Ste 103",
            "city": "Sioux Falls",
            "state": "SD",
            "country_code": "US",
            "postal_code": "571085054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.wellnesscollectivesd.com",
            "affiliation": "N",
            "address_1": "2333 W 57th St Ste 103",
            "city": "Sioux Falls",
            "state": "SD",
            "country_code": "US",
            "postal_code": "571085054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.