Individual provider Active NPI

Karen M. Connors, ACSW,LICSW

  • Clinical Social Worker
  • North Kingstown, RI
National Provider Identifier
1184636573
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW00436 Issued in RI
Practice address
1130 Ten Rod Rd
Suite D104
North Kingstown, RI 02852-4161
Phone
(401) 295-5575
Fax
(401) 295-5552
NPI assigned
Aug 13, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 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 ISW00436 RI Primary

Addresses

Primary practice location

1130 Ten Rod Rd
Suite D104
North Kingstown, RI 02852-4161

Mailing address

1130 Ten Rod Rd
Suite D104
North Kingstown, RI 02852-4161
Phone (401) 295-5575

Other identifiers 8

IdentifierTypeStateIssuer
406748OtherRIRI BLUE CHIP
KC04097MedicaidRI
1038100OtherRIBEACON HEALTH STRATEGIES
9009367MedicaidRI
384434OtherRIVALUE OPTIONS
9367-3OtherRIRI BLUE CROSS
246128OtherRIMAGELLAN BEH CARE
62-25675OtherRIUBH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20040720000946 RI Practitioner - Clinical Social Worker 3971583170 Practice locations: N Kingstown, RI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1130 Ten Rod Rd
Suite D305B
North Kingstown, RI 02852-4181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW00436RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Martha Dempster, Licsw, LLC 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, 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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1184636573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 TEN ROD RD",
            "address_2": "SUITE D104",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028524161",
            "telephone_number": "401-295-5575",
            "fax_number": "401-295-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 TEN ROD RD",
            "address_2": "SUITE D104",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028524161",
            "telephone_number": "401-295-5575",
            "fax_number": "401-295-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNORS",
        "first_name": "KAREN",
        "middle_name": "M.",
        "credential": "ACSW,LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW00436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI BLUE CHIP",
            "identifier": "406748",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "KC04097",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON HEALTH STRATEGIES",
            "identifier": "1038100",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9009367",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "384434",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI BLUE CROSS",
            "identifier": "9367-3",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BEH CARE",
            "identifier": "246128",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "62-25675",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Kingstown, RI

Sources for this page

Verify at the official NPI Registry.