Individual provider Active NPI

Pamela Kummerer, LISW, LICDC

  • Addiction (Substance Use Disorder) Counselor
  • Toledo, OH
National Provider Identifier
1235530668
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
I 1302843 Issued in OH
Practice address
2465 Collingwood Blvd
Toledo, OH 43620-1153
Phone
(419) 241-8827
NPI assigned
Sep 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X I 1302843 OH Primary

Addresses

Primary practice location

2465 Collingwood Blvd
Toledo, OH 43620-1153

Mailing address

5421 Grey Dr
Sylvania, OH 43560-2411
Phone (419) 241-8827

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240321000111 OH Practitioner - Clinical Social Worker 0648580399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Zepf CenterGroup PAC ID 5395639215, 43 clinicians

Practice addresses (Care Compare)

6605 W Central Ave
Suite 100
Toledo, OH 43617-1000
Phone (419) 841-7701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I 1302843OHMDAddiction (Substance Use Disorder) Counselor

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": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1235530668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5421 GREY DR",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602411",
            "telephone_number": "419-241-8827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2465 COLLINGWOOD BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436201153",
            "telephone_number": "419-241-8827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMMERER",
        "first_name": "PAMELA",
        "credential": "LISW, LICDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-04",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "I 1302843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.