Individual provider Active NPI

Karen L Hammond, MSW LCSW

  • Clinical Social Worker
  • Dacatur, IL
National Provider Identifier
1174631279
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1770 E Lake Shore Dr
Suite 209
Dacatur, IL 62521
Phone
(217) 428-0600
Fax
(217) 423-6536
NPI assigned
Aug 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

1770 E Lake Shore Dr
Suite 209
Dacatur, IL 62521

Mailing address

1770 E Lake Shore Dr
Suite 209
Dacatur, IL 62521
Phone (217) 428-0600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20220602001084 IL Practitioner - Clinical Social Worker 9436537586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rohidas T Patil MD SCGroup PAC ID 5092772285, 4 clinicians

Practice addresses (Care Compare)

1770 E Lake Shore Dr
Suite 209
Decatur, IL 62521-3823
Phone (217) 423-6500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149005734ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rohidas T Patil MD SC CurrentSince May 9, 2022 Accepting new patients
John Herington, PC Clinical PastSince May 9, 2022 Accepting new patients

Locations

1770 E Lake Shore Dr
Ste 209
Decatur, IL 62521
Phone (217) 423-6500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174631279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 E LAKE SHORE DR",
            "address_2": "SUITE 209",
            "city": "DACATUR",
            "state": "IL",
            "postal_code": "62521",
            "telephone_number": "217-428-0600",
            "fax_number": "217-423-6536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 E LAKE SHORE DR",
            "address_2": "SUITE 209",
            "city": "DACATUR",
            "state": "IL",
            "postal_code": "62521",
            "telephone_number": "217-428-0600",
            "fax_number": "217-423-6536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMOND",
        "first_name": "KAREN",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "MSW LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dacatur, IL

Sources for this page

Verify at the official NPI Registry.