Individual provider Active NPI

Kathryn A Branson, LMSW

  • Clinical Social Worker
  • Wyandotte, MI
National Provider Identifier
1104583988
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801093363 Issued in MI
Practice address
2300 Biddle Ave Ste 100
Wyandotte, MI 48192-4650
Phone
(734) 246-5705
Fax
(734) 246-5750
NPI assigned
Nov 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801093363 MI Primary

Addresses

Primary practice location

2300 Biddle Ave Ste 100
Wyandotte, MI 48192-4650

Mailing address

2300 Biddle Ave Ste 100
Wyandotte, MI 48192-4650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20211214001585 MI Practitioner - Clinical Social Worker 0042600694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ghazwan Atto MD PCGroup PAC ID 4789694837, 12 clinicians

Practice addresses (Care Compare)

2300 Biddle Ave
Suite 100
Wyandotte, MI 48192-4650
Phone (734) 246-5705

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801093363MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dma Urgent Care, PLLC CurrentSince Dec 1, 2021 Accepting new patients
Ghazwan Atto MD PC CurrentSince Dec 1, 2021 Accepting new patients

Locations

2300 Biddle Ave
#100
Wyandotte, MI 48192
Phone (734) 246-5705

Interoperability endpoints

  • Direct secure messaging: kbranson237024@direct.hfhs.org

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": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1104583988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 BIDDLE AVE STE 100",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481924650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 BIDDLE AVE STE 100",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481924650",
            "telephone_number": "734-246-5705",
            "fax_number": "734-246-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANSON",
        "first_name": "KATHRYN",
        "middle_name": "A",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-29",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801093363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyandotte, MI

Sources for this page

Verify at the official NPI Registry.