Active NPI
Mandy Jo Ellison, LMSW
- Social Worker
- Springville, IA
National Provider Identifier
1972058782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 082170
- Practice address
- 973 County Home Rd
Springville, IA 52336-9711 - Phone
- (319) 213-0884
- NPI assigned
- Aug 22, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 082170 | IA | Primary |
Addresses
Primary practice location
973 County Home Rd
Springville, IA 52336-9711
Mailing address
973 County Home Rd
Springville, IA 52336-9711
Phone (319) 213-0884
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 082170 | IA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Abbe Center at St Lukes | Past | Accepting new patients |
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Hiawatha, IA
- NPI 1215231642
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471824000000",
"number": "1972058782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "973 COUNTY HOME RD",
"city": "SPRINGVILLE",
"state": "IA",
"postal_code": "523369711",
"telephone_number": "319-213-0884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "973 COUNTY HOME RD",
"city": "SPRINGVILLE",
"state": "IA",
"postal_code": "523369711",
"telephone_number": "319-213-0884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLISON",
"first_name": "MANDY",
"middle_name": "JO",
"name_prefix": "Mrs.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-22",
"last_updated": "2016-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IA",
"license": "082170",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springville, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.