Individual provider Active NPI

Vernon C Rickert Jr., LCSW LMFT

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1073566220
Registry record updated Nov 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0214 Issued in KY
Practice address
9319 Taylorsville Rd
Louisville, KY 40299-1737
Phone
(502) 592-8195
Fax
(502) 618-2609
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0214 KY Primary
Marriage & Family Therapist 106H00000X 0252 KY

Addresses

Primary practice location

9319 Taylorsville Rd
Louisville, KY 40299-1737

Mailing address

17501 Fisherville Woods Dr
Fisherville, KY 40023-9781
Phone (502) 267-5418

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
I20060901000047 KY Practitioner - Clinical Social Worker 1557365624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hagan Health LLCGroup PAC ID 5890129159, 8 clinicians

Practice addresses (Care Compare)

4010 Dupont Cir
Suite 202
Louisville, KY 40207-4847
Phone (502) 326-3011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0252KYMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hagan Health LLC Clinical CurrentSince Nov 15, 2019 Accepting new patients
MDC2 LLC Clinical Past Accepting new patients
Vern Rickert Counseling Marriage & Family Therapist Past Accepting new patients

Locations

4010 DuPont Cir
Ste 202
Louisville, KY 40207
Phone (502) 326-3011

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289952000000",
    "number": "1073566220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17501 FISHERVILLE WOODS DR",
            "city": "FISHERVILLE",
            "state": "KY",
            "postal_code": "400239781",
            "telephone_number": "502-267-5418",
            "fax_number": "502-618-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9319 TAYLORSVILLE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402991737",
            "telephone_number": "502-592-8195",
            "fax_number": "502-618-2609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKERT",
        "first_name": "VERNON",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW  LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2010-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "0214",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KY",
            "license": "0252",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.