Individual provider Active NPI

Kristi L Meyer, LCSW, ADS

  • Clinical Social Worker
  • Canon City, CO
National Provider Identifier
1275718215
Registry record updated Nov 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09923601 Issued in CO
Practice address
1231 Baldwin Ave
Canon City, CO 81212-4927
Phone
(605) 390-3744
Fax
(719) 452-3752
NPI assigned
Jan 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2220 SD
Clinical Social Worker 1041C0700X CSW.09923601 CO Primary

Addresses

Primary practice location

1231 Baldwin Ave
Canon City, CO 81212-4927

Mailing address

1231 Baldwin Ave
Canon City, CO 81212-4927
Phone (605) 390-3744

Other names 1

  • Kristi L Meyer Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20141231000513 CO Practitioner - Clinical Social Worker 8527249390 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Life Counseling and Consulting PLLCGroup PAC ID 0042592123, 3 clinicians

Practice addresses (Care Compare)

831 Royal Gorge Blvd
Suite 217
Canon City, CO 81212-6709
Phone (719) 221-8451

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW.09923601COMDClinical Social Worker
2220SDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pueblo Community Health Center Inc CurrentSince Nov 16, 2015 Accepting new patients
Pueblo Community Health Center Inc CurrentSince Nov 16, 2015 Accepting new patients
Life Counseling and Consulting, PLLC Clinical CurrentSince Dec 24, 2016 Accepting new patients

Locations

831 Royal Gorge Blvd
Ste 217
Canon City, CO 81212
Phone (719) 221-8451

110 E Routt Ave
Pueblo, CO 81004
Phone (719) 543-8718

300 Colorado Ave
Pueblo, CO 81004
Phone (719) 543-8718

Organizations & group practices 3

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": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478649600000",
    "number": "1275718215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 BALDWIN AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812124927",
            "telephone_number": "605-390-3744",
            "fax_number": "719-452-3752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 BALDWIN AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812124927",
            "telephone_number": "605-390-3744",
            "fax_number": "719-452-3752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "KRISTI",
        "middle_name": "L",
        "credential": "LCSW, ADS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-09",
        "last_updated": "2016-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SD",
            "license": "2220",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09923601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTI",
            "last_name": "MEYER",
            "middle_name": "L",
            "credential": "LCSW, ADS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Canon City, CO

Sources for this page

Verify at the official NPI Registry.