Kimberly Haubner

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34010140A Issued in IN

Practice address

2100 N Main St # 304
Crown Point, IN 46307-1877

Phone

(574) 546-1900

Fax

(574) 546-1999

NPI assigned

Nov 29, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH, KY, IN3 enrollments

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 3

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Neurology and Pain Management Associates PCGroup PAC ID 4486676095, 86 clinicians

Guidestar Eldercare Corp -OhGroup PAC ID 9739504523, 43 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.06 of 100Reported as group

Quality

80.07

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

92.91 of 100Reported as group

Quality

79.89

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Neurology and Pain Management Associates PC

  • Internal Medicine Physician
  • Crown Point, IN
  • NPI 1518900620

  Clinical, KY

  Medicare reassignment Care Compare group NPD
• Guidestar Eldercare Corp -Oh

  • Internal Medicine Physician
  • Columbus, OH
  • NPI 1962023424

  Clinical

  Medicare reassignment Care Compare group NPD
• 360Care Services of Kentucky LLC

  • Social Worker
  • Louisville, KY
  • NPI 1669113023
  Medicare reassignment NPD
• 360Team Counseling LLC

  • Psychologist
  • Perrysburg, OH
  • NPI 1881277242

  Social Worker

  Medicare reassignment NPD
• 360Care Services of Kentucky LLC

  • Nurse Practitioner
  • Louisville, KY
  • NPI 1174394852
  NPD
• Greenhouse and Associates Inc.

  • Clinical Psychologist
  • Indianapolis, IN
  • NPI 1114237336
  NPD (past)

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

{
    "created_epoch": "1511913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1265946263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 MADISON RD",
            "city": "WALNUT HILLS",
            "state": "OH",
            "postal_code": "452061706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N MAIN ST # 304",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463071877",
            "telephone_number": "574-546-1900",
            "fax_number": "574-546-1999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "306 W Main St Ste 512",
            "address_purpose": "LOCATION",
            "city": "Frankfort",
            "state": "KY",
            "postal_code": "406011840",
            "country_code": "US",
            "telephone_number": "574-546-1900",
            "fax_number": "574-546-1999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1501 Madison Rd",
            "address_purpose": "LOCATION",
            "city": "Walnut Hills",
            "state": "OH",
            "postal_code": "452061706",
            "country_code": "US",
            "telephone_number": "513-354-5200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21 E State St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432154281",
            "country_code": "US",
            "telephone_number": "574-546-1900",
            "fax_number": "574-546-1999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAUBNER",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-29",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "254980",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34010140A",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1800886",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "N-A-1",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Ann Verbeke Hartman, LCSW
• Michael Harvey Jr.
• Ashraf Syed Hasan, MD
• Cory Hasik, RN
• Jennifer Hathaway, LCSW
• Shalandria Hawkins, MS
• Hayes Dentistry PC
• Hayes Family Chiropractic PC
• Ally Mackenzie Hayes
• Danny L Hayes, DMD

• Clinical Social Worker in Crown Point, IN
• Providers in Crown Point, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.