NPIMap

Individual provider Active NPI

Karen Ronnetta Trail, LSW

  • Social Worker
  • Toledo, OH
National Provider Identifier
1043665946
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S 0028531 Issued in OH
Practice address
6715 Dorr St
Toledo, OH 43615
Phone
(419) 868-1178
Fax
(419) 868-1989
NPI assigned
Apr 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X
Social Worker 104100000X S 0028531 OH Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

6715 Dorr St
Toledo, OH 43615

Mailing address

PO Box 400
Holland, OH 43528
Phone (419) 491-8828

Other identifiers 1

IdentifierTypeStateIssuer
0295285MedicaidOH

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

LicenseStateTypeSpecialty
S 0028531OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Teaching Homes, Inc. CurrentSince Nov 22, 2020 Accepting new patients
Volunteers of America Ohio & Indiana Past Accepting new patients
Community Teaching Homes, Inc. PastSince Nov 22, 2020 Accepting new patients

Locations

6715 Dorr St
Toledo, OH 43615
Phone (419) 868-1178

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/voaohin/r4/

Organizations & group practices 3

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": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1043665946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "43528",
            "telephone_number": "419-491-8828",
            "fax_number": "419-868-1989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6715 DORR ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43615",
            "telephone_number": "419-868-1178",
            "fax_number": "419-868-1989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAIL",
        "first_name": "KAREN",
        "middle_name": "RONNETTA",
        "name_prefix": "Mrs.",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-28",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S 0028531",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0295285",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.