Individual provider Active NPI

Kathryn Kirkman White, MSW

  • Social Worker
  • Portland, OR
National Provider Identifier
1316245152
Registry record updated Mar 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
L6162 Issued in OR
Practice address
3930 SE Division St
Portland, OR 97202-1643
Phone
(503) 418-3735
NPI assigned
Mar 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 11-06-44 OR
Social Worker 104100000X L6162 OR Primary

Addresses

Primary practice location

3930 SE Division St
Portland, OR 97202-1643

Mailing address

1132 SW 13TH Ave
Portland, OR 97205-1703
Phone (503) 535-7570

Other identifiers 1

IdentifierTypeStateIssuer
1568401347MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20170802001052 OR Practitioner - Clinical Social Worker 0042581563 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
Group practices

Practice addresses (Care Compare)

51377 SW Old Portland Rd
Scappoose, OR 97056-4023
Phone (503) 418-4222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Health & Science University Current Accepting new patients
Oregon Health & Science University CurrentSince Aug 25, 2017 Accepting new patients
Oregon Health & Science University CurrentSince Aug 25, 2017 Accepting new patients

Locations

3930 SE Division St
Portland, OR 97202
Phone (503) 418-3900

51377 SW Old Portland Rd
Scappoose, OR 97056
Phone (503) 418-4222

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": "1299024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1316245152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 SW 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051703",
            "telephone_number": "503-535-7570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021643",
            "telephone_number": "503-418-3735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KATHRYN",
        "middle_name": "KIRKMAN",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-02",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "11-06-44",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OR",
            "license": "L6162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568401347",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.