Active NPI
Marideth Kates
- Clinical Social Worker
- Evansville, IN
National Provider Identifier
1063622405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34004955A
- Practice address
- 7300 E Indiana St Ste 103
Evansville, IN 47715-2794 - Phone
- (812) 401-8008
- Fax
- (812) 401-8201
- NPI assigned
- May 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34004955A | IN | Primary |
Addresses
Primary practice location
7300 E Indiana St Ste 103
Evansville, IN 47715-2794
Mailing address
PO Box 3276
Evansville, IN 47731-3276
Phone (812) 473-0181
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34004955A | IN | MD | Clinical Social Worker |
Interoperability endpoints
- mbh.maridethkates@140099.advancedmd-direct.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444003200000",
"number": "1063622405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3276",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477313276",
"telephone_number": "812-473-0181",
"fax_number": "812-473-5822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7300 E INDIANA ST STE 103",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477152794",
"telephone_number": "812-401-8008",
"fax_number": "812-401-8201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KATES",
"first_name": "MARIDETH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-23",
"last_updated": "2015-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34004955A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.