Individual provider Active NPI

Kelsey Magnuson

  • Social Worker
  • Westerville, OH
National Provider Identifier
1104368620
Registry record updated Nov 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I.1451353 Issued in OH
Practice address
187 W Schrock Rd
Westerville, OH 43081-2890
Phone
(614) 355-7500
Fax
(614) 355-7533
NPI assigned
Nov 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2016

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 I.1451353 OH Primary

Addresses

Primary practice location

187 W Schrock Rd
Westerville, OH 43081-2890

Mailing address

Dept 781625
Detroit, MI 48278-1625
Phone (614) 355-8004

Other identifiers 1

IdentifierTypeStateIssuer
2846675MedicaidOH

Other names 1

  • Klesey McIntyre Former name

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
I.1451353OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nationwide Children'S Hospital 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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1104368620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 781625",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781625",
            "telephone_number": "614-355-8004",
            "fax_number": "614-355-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 W SCHROCK RD",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430812890",
            "telephone_number": "614-355-7500",
            "fax_number": "614-355-7533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGNUSON",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-15",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.1451353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2846675",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KLESEY",
            "last_name": "MCINTYRE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Westerville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; 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.