Individual provider Active NPI

Kaitlin Marie Cary-King

  • Social Worker
  • Hartland, WI
National Provider Identifier
1073115366
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
131676121 Issued in WI
Practice address
155 E Capitol Dr Ste 4
Hartland, WI 53029-2134
Phone
(920) 728-3125
NPI assigned
Nov 11, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 131676121 WI Primary

Addresses

Primary practice location

155 E Capitol Dr Ste 4
Hartland, WI 53029-2134

Mailing address

155 E Capitol Dr Ste 4
Hartland, WI 53029-2134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20220613000056 WI Practitioner - Clinical Social Worker 5193103638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathways Counseling Center II LLCGroup PAC ID 7315970969, 9 clinicians

Practice addresses (Care Compare)

11121 W Oklahoma Ave
West Allis, WI 53227-4033
Phone (262) 641-9790

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
131676121WIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Counseling Center II LLC CurrentSince Jun 1, 2022 Accepting new patients
Allergic Diseases SC PastSince Jun 1, 2022 Accepting new patients

Locations

11121 W Oklahoma Ave
West Allis, WI 53227
Phone (262) 641-9790

Organizations & group practices 2

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": "1605052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1073115366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 E CAPITOL DR STE 4",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "530292134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 E CAPITOL DR STE 4",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "530292134",
            "telephone_number": "920-728-3125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARY-KING",
        "first_name": "KAITLIN",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-11",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "131676121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartland, WI

Sources for this page

Verify at the official NPI Registry.