Individual provider Active NPI

Regina Bramer Wheatley, LCSW

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1023484474
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
KY1798 Issued in KY
Practice address
914 Lily Creek Rd Ste 101
Louisville, KY 40243-2815
Phone
(502) 805-5858
NPI assigned
Aug 19, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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 KY1798 KY Primary

Addresses

Primary practice location

914 Lily Creek Rd Ste 101
Louisville, KY 40243-2815

Mailing address

1519 Baxter Avenue
Louisville, KY 40205
Phone (502) 409-7181

Other names 1

  • Gina Wheatley Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20220413001781 KY Practitioner - Clinical Social Worker 4688060932 Reassigns benefits to 1 organization
Practice locations: Louisville, KY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Chronic Illness Counseling Center LLCGroup PAC ID 3274930896, 10 clinicians

Practice addresses (Care Compare)

13804 Lake Point Cir
Suite 101
Louisville, KY 40223-4239
Phone (502) 805-5858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
KY1798KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Chronic Illness Counseling Center LLC Clinical CurrentSince Apr 1, 2022 Accepting new patients

Locations

914 Lily Creek Rd
Ste 101
Louisville, KY 40243
Phone (502) 805-5858

914 Lily Creek Rd
Ste 102
Louisville, KY 40243
Phone (502) 592-3583

13804 Lake Point Cir
Ste 101
Louisville, KY 40223
Phone (502) 245-7258

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": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1023484474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1519 BAXTER AVENUE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40205",
            "telephone_number": "502-409-7181",
            "fax_number": "502-409-7181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 LILY CREEK RD STE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402432815",
            "telephone_number": "502-805-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEATLEY",
        "first_name": "REGINA",
        "middle_name": "BRAMER",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-19",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "KY1798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "WHEATLEY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.