Active NPI
Misty Keolavone, LSCSW
- Social Worker
- Hutchinson, KS
National Provider Identifier
1093986168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 4421
- Practice address
- 500 Reformatory St
Hutchinson, KS 67501-3081 - Phone
- (620) 662-2321
- NPI assigned
- Mar 17, 2008
- Last updated
- Jul 10, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 4421 | KS | Primary |
Addresses
Primary practice location
500 Reformatory St
Hutchinson, KS 67501-3081
Mailing address
628 High Plains Cir
Maize, KS 67101-9309
Phone (316) 655-3881
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4421 | KS | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Sedgwick | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba COMCARE of Sedgwick County
- Community/Behavioral Health Agency
- Wichita, KS
- NPI 1982351706
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720569600000",
"number": "1093986168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "628 HIGH PLAINS CIR",
"city": "MAIZE",
"state": "KS",
"postal_code": "671019309",
"telephone_number": "316-655-3881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 REFORMATORY ST",
"city": "HUTCHINSON",
"state": "KS",
"postal_code": "675013081",
"telephone_number": "620-662-2321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEOLAVONE",
"first_name": "MISTY",
"credential": "LSCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-17",
"last_updated": "2024-07-10",
"certification_date": "2024-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "KS",
"license": "4421",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hutchinson, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.