Individual provider Active NPI

Caitlin Amanda Keptner, LCSW

  • Clinical Social Worker
  • Tacoma, WA
National Provider Identifier
1013255074
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LSCSW05711 Issued in KS
Practice address
9040 Jackson Ave
Tacoma, WA 98431-2858
Phone
(253) 968-4157
NPI assigned
Jan 26, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LW60687765 WA
Clinical Social Worker 1041C0700X CW019081 PA
Clinical Social Worker 1041C0700X LSCSW05711 KS Primary

Addresses

Primary practice location

9040 Jackson Ave
Tacoma, WA 98431-2858

Mailing address

720 Poyntz Ave
Manhattan, KS 66502-6355
Phone (785) 320-7331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, KS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200623001242 WA Practitioner - Clinical Social Worker 1759678030 Reassigns benefits to 1 organization
I20221117001771 KS Practitioner - Clinical Social Worker 1759678030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Courser Lapo IncGroup PAC ID 4183055270, 11 clinicians

Practice addresses (Care Compare)

1913 M St
Belleville, KS 66935-2238
Phone (785) 527-8271

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LSCSW05711KSMDClinical Social Worker
CW019081PAMDClinical Social Worker
LW60687765WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Jun 8, 2020 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Jun 8, 2020 Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

Organizations & group practices 4

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": "1359158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1013255074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 POYNTZ AVE",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665026355",
            "telephone_number": "785-320-7331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984312858",
            "telephone_number": "253-968-4157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEPTNER",
        "first_name": "CAITLIN",
        "middle_name": "AMANDA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-26",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60687765",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW019081",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "LSCSW05711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.