Individual provider Active NPI

Karen Anne McGavin, LCSW

  • Clinical Social Worker
  • Fort Walton Beach, FL
National Provider Identifier
1215185681
Registry record updated Feb 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW11541 Issued in FL
Practice address
137 Hospital Dr NE
Fort Walton Beach, FL 32548-5063
Phone
(850) 833-7451
Fax
(850) 833-7439
NPI assigned
Aug 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 2139M AR
Clinical Social Worker 1041C0700X SW11541 FL Primary

Addresses

Primary practice location

137 Hospital Dr NE
Fort Walton Beach, FL 32548-5063

Mailing address

137 Hospital Dr NE
Fort Walton Beach, FL 32548-5063
Phone (850) 833-7500

Other identifiers 1

IdentifierTypeStateIssuer
009913300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2139MARMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392854400000",
    "number": "1215185681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 HOSPITAL DR NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485063",
            "telephone_number": "850-833-7500",
            "fax_number": "850-833-7439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 HOSPITAL DR NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485063",
            "telephone_number": "850-833-7451",
            "fax_number": "850-833-7439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGAVIN",
        "first_name": "KAREN",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-28",
        "last_updated": "2014-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "2139M",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009913300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; 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.