Ken Fitzwater

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

1910 Fairgrove Ave Ste E
Hamilton, OH 45011-1930

Phone

(513) 795-7557

NPI assigned

Feb 26, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5507/brand/1/csg/1/fhir/r4
• FHIR API: https://api.qualifacts.org/api/fhir/mpwhealth/r4/

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.

• Modern Psychiatry & Wellness, LLC

  • Adult Mental Health Clinic/Center
  • Hamilton, OH
  • NPI 1699251553
  NPD
• Modern Psychiatry and Wellness LLC

  • Adult Mental Health Clinic/Center
  • Hamilton, OH
  • NPI 1225260888
  NPD
• Decoach Team LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Cincinnati, OH
  • NPI 1366992224
  NPD (past)
• Decoach Team LLC

  • Adult Mental Health Clinic/Center
  • Cincinnati, OH
  • NPI 1578037552
  NPD (past)

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

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1104450352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 FAIRGROVE AVE STE E",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450111930",
            "telephone_number": "513-795-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 FAIRGROVE AVE STE E",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450111930",
            "telephone_number": "513-795-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZWATER",
        "first_name": "KEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-26",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": "CDCA.172918",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• First Cincinnati Physic
• Christina Lynn Fishbaugh-Cooper
• Ashley Fisher
• Kelly Marie Fisher
• Quincy T Fisher
• Stacey Lynne Flanigan
• Jennifer Marie Flannery, LMT
• Catherine Jean Flem, NP
• Kassidy L Fleming
• Kelly L Fleming

• Counselor in Hamilton, OH
• Providers in Hamilton, OH by specialty
• Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.