Individual provider Active NPI

Kevin Michael Waite

  • Social Worker
  • Walnut Hills, OH
National Provider Identifier
1295246890
Registry record updated Oct 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.1600816 Issued in OH
Practice address
1501 Madison Rd
Walnut Hills, OH 45206-1706
Phone
(513) 354-5200
NPI assigned
Oct 23, 2017
Last updated
Oct 23, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.1600816 OH Primary

Addresses

Primary practice location

1501 Madison Rd
Walnut Hills, OH 45206-1706

Mailing address

1501 Madison Rd
Walnut Hills, OH 45206-1706

Other identifiers 1

IdentifierTypeStateIssuer
S.1600816OtherOHLICENSURE

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
I20190913002817 OH Practitioner - Clinical Social Worker 3072842103 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.1600816OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Cincinnati Behavioral Health Services Current Accepting new patients
Greater Cincinnati Behavioral Health Services CurrentSince Jul 8, 2019 Accepting new patients
Greater Cincinnati Behavioral Health Services CurrentSince Jul 8, 2019 Accepting new patients
Greater Cincinnati Behavioral Health Services Past Accepting new patients

Locations

1501 Madison Rd
Walnut Hills, OH 45206
Phone (513) 354-7000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508716800000",
    "number": "1295246890",
    "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": "1501 MADISON RD",
            "city": "WALNUT HILLS",
            "state": "OH",
            "postal_code": "452061706",
            "telephone_number": "513-354-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAITE",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-23",
        "last_updated": "2017-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1600816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "S.1600816",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Hills, OH

Sources for this page

Verify at the official NPI Registry.