Active NPI
Benjamin Stewart Hoertz
- Clinical Social Worker
- Louisville, KY
National Provider Identifier
1215774153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 259382
- Practice address
- 1169 Eastern Pkwy Ste 3364
Louisville, KY 40217-1415 - Phone
- (502) 813-8280
- Fax
- (502) 473-1334
- NPI assigned
- Jul 9, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 259382 | KY | Primary |
Addresses
Primary practice location
1169 Eastern Pkwy Ste 3364
Louisville, KY 40217-1415
Mailing address
10100 Elida Rd
Delphos, OH 45833-9058
Phone (419) 695-8010
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 259382 | Other | KY | CSW |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 259382 | KY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720483200000",
"number": "1215774153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10100 ELIDA RD",
"city": "DELPHOS",
"state": "OH",
"postal_code": "458339058",
"telephone_number": "419-695-8010",
"fax_number": "606-451-1631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1169 EASTERN PKWY STE 3364",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402171415",
"telephone_number": "502-813-8280",
"fax_number": "502-473-1334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOERTZ",
"first_name": "BENJAMIN",
"middle_name": "STEWART",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-07-09",
"last_updated": "2024-07-09",
"certification_date": "2024-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KY",
"license": "259382",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CSW",
"identifier": "259382",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.