Kendall Runnebaum, LSCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4472 Issued in KS

Practice address

1005 N Buckeye Ave
Abilene, KS 67410-1940

Phone

(785) 236-8612

Fax

(785) 783-5366

NPI assigned

Nov 4, 2009

Last updated

May 31, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kendall Conner Former name

Medicare fee-for-service enrollment

Enrolled in KS

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

Specialty

Clinical Social Worker

Education

University of Kansas School of Med (KC/Wich/Sal), 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Freedom Behavioral Health Solutions LLCGroup PAC ID 3577909431, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Freedom Behavioral Health Solutions, LLC

  • Psychiatry Physician
  • Manhattan, KS
  • NPI 1245006493
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1257292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590883200000",
    "number": "1033446596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 N BUCKEYE AVE",
            "city": "ABILENE",
            "state": "KS",
            "postal_code": "674101940",
            "telephone_number": "785-236-8612",
            "fax_number": "785-783-5366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 N BUCKEYE AVE",
            "city": "ABILENE",
            "state": "KS",
            "postal_code": "674101940",
            "telephone_number": "785-236-8612",
            "fax_number": "785-783-5366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNNEBAUM",
        "first_name": "KENDALL",
        "credential": "LSCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-04",
        "last_updated": "2020-05-31",
        "certification_date": "2020-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "578",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "4472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENDALL",
            "last_name": "CONNER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Teri Raub, PTA
• Roxanne Roberts, DPT
• Timothy Lee Roeser, DNP APRN NP--C
• Sara Lynn Rosebrook, R.D., L.D.
• Stephen Anthony Ruhlman, MD
• Thomas Richard Saffell, DDS
• Tracie Schardein, LPC-T
• Joshua Nicholas Schell, APRN
• Trenton James Schmidt
• Nicholas C Schulte, DDS

• Clinical Social Worker in Abilene, KS
• Providers in Abilene, KS by specialty
• Clinical Social Worker in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.