Individual provider Active NPI

Kelsey Painter

  • Clinical Social Worker
  • Roanoke, VA
National Provider Identifier
1124835582
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904017771 Issued in VA
Practice address
611 McDowell Ave NW
Roanoke, VA 24016-1225
Phone
(540) 266-9200
NPI assigned
Dec 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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 0904017771 VA Primary

Addresses

Primary practice location

611 McDowell Ave NW
Roanoke, VA 24016-1225

Mailing address

301 Elm Ave SW
Roanoke, VA 24016-4001
Phone (540) 266-9200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20250207002178 VA Practitioner - Clinical Social Worker 5092245944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Ridge Behavioral HealthcareGroup PAC ID 6709831522, 26 clinicians

Practice addresses (Care Compare)

611 McDowell Ave NW
Roanoke, VA 24016-1225
Phone (540) 266-9200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Behavioral Healthcare CurrentSince Jan 1, 2025 Accepting new patients

Locations

301 Elm Ave SW
Roanoke, VA 24016
Phone (540) 266-9200

611 McDowell Ave NW
Roanoke, VA 24016
Phone (540) 266-9200

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": "1734480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1124835582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 ELM AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164001",
            "telephone_number": "540-266-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 MCDOWELL AVE NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240161225",
            "telephone_number": "540-266-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAINTER",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-18",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904017771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.