Individual provider Active NPI

Taryn Joelle Hancock, LISW

  • Clinical Social Worker
  • Davenport, IA
National Provider Identifier
1992846448
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
06721 Issued in IA
Practice address
1345 W Central Park Ave
Davenport, IA 52804-1844
Phone
(563) 421-4406
NPI assigned
Feb 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149011719 IL
Clinical Social Worker 1041C0700X 06721 IA Primary

Addresses

Primary practice location

1345 W Central Park Ave
Davenport, IA 52804-1844

Mailing address

1112 20TH Ave
East Moline, IL 61244-2222
Phone (309) 558-9760

Other identifiers 1

IdentifierTypeStateIssuer
06721OtherIALISW

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address taryn.hancock@direct.genesishealth.com Direct

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
I20090521000168 IA Practitioner - Clinical Social Worker 7810046869 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Health SystemGroup PAC ID 7214841436, 217 clinicians

Practice addresses (Care Compare)

1345 W Central Park Ave
Mercyone Genesis Family Medical Cen
Davenport, IA 52804-1844
Phone (563) 421-4400

619 5TH St
Durant, IA 52747-7737
Phone (563) 785-4487

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149011719ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System CurrentSince Oct 16, 2017 Accepting new patients
Vera French Community Mental Health CurrentSince Apr 4, 2009 Accepting new patients
Genesis Health System CurrentSince Oct 16, 2017 Accepting new patients
Vera French Community Mental Health PastSince Dec 10, 2023 Accepting new patients

Locations

852 Middle Rd
Ste 101
Bettendorf, IA 52722
Phone (563) 383-1900

210 W 53rd St
Davenport, IA 52806
Phone (563) 386-3436

1345 W Central Park Ave
Davenport, IA 52804
Phone (563) 421-4400

1351 W Central Park Ave
Ste 340
Davenport, IA 52804
Phone (563) 421-1287

1441 W Central Park Ave
Davenport, IA 52804
Phone (563) 383-1900

619 5th St
Durant, IA 52747
Phone (563) 785-4487

Interoperability endpoints

  • Direct secure messaging: taryn.hancock@direct.genesishealth.com

Organizations & group practices 5

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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1992846448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 20TH AVE",
            "city": "EAST MOLINE",
            "state": "IL",
            "postal_code": "612442222",
            "telephone_number": "309-558-9760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 W CENTRAL PARK AVE",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528041844",
            "telephone_number": "563-421-4406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANCOCK",
        "first_name": "TARYN",
        "middle_name": "JOELLE",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149011719",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "06721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISW",
            "identifier": "06721",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "taryn.hancock@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "Genesis Health System Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1345 W Central Park Ave",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528041844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.