Individual provider Active NPI

Kelly A Mayer

  • Clinical Social Worker
  • Cedar Rapids, IA
National Provider Identifier
1962990267
Registry record updated Apr 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
086240 Issued in IA
Practice address
1030 5TH Ave SE Ste 3000
Cedar Rapids, IA 52403-2416
Phone
(319) 365-9164
NPI assigned
Apr 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2018

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 086240 IA Primary

Addresses

Primary practice location

1030 5TH Ave SE Ste 3000
Cedar Rapids, IA 52403-2416

Mailing address

1030 5TH Ave SE Ste 3000
Cedar Rapids, IA 52403-2416
Phone (319) 365-9164

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230425002280 IA Practitioner - Clinical Social Worker 6103281241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1290 Jordan St
North Liberty, IA 52317-8020
Phone (319) 432-0531

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
086240IAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Associates of Iowa, PC CurrentSince Mar 1, 2023 Accepting new patients
Psychiatric Associates of Iowa, PC CurrentSince Mar 1, 2023 Accepting new patients

Locations

3900 Fountains Blvd NE
Ste 203
Cedar Rapids, IA 52411
Phone (319) 727-8297

673 Westbury Dr
Ste 201
Iowa City, IA 52245
Phone (319) 356-6352

2545 N Dodge St
Ste C
Iowa City, IA 52245
Phone (319) 249-0307

1290 Jordan St
North Liberty, IA 52317
Phone (319) 356-6352

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524441600000",
    "number": "1962990267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 5TH AVE SE STE 3000",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524032416",
            "telephone_number": "319-365-9164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 5TH AVE SE STE 3000",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524032416",
            "telephone_number": "319-365-9164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYER",
        "first_name": "KELLY",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-23",
        "last_updated": "2018-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "086240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.