Individual provider Active NPI

Katherine H.B. Dimitre, LCSW

  • Clinical Social Worker
  • Ashland, OR
National Provider Identifier
1336273689
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
901 Beach St
Ashland, OR 97520-3238
Phone
(541) 772-3349
Fax
(541) 772-3349
NPI assigned
Mar 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X OR Primary

Addresses

Primary practice location

901 Beach St
Ashland, OR 97520-3238

Mailing address

PO Box 1332
Ashland, OR 97520-0045
Phone (541) 772-3349

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
I20080304000149 OR Practitioner - Clinical Social Worker 6608950498 Practice locations: Ashland, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

901 Beach St
Ashland, OR 97520-3238
Phone (541) 772-3349

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1336273689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1332",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975200045",
            "telephone_number": "541-772-3349",
            "fax_number": "541-772-3349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 BEACH ST",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975203238",
            "telephone_number": "541-772-3349",
            "fax_number": "541-772-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMITRE",
        "first_name": "KATHERINE",
        "middle_name": "H.B.",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, OR

Sources for this page

Verify at the official NPI Registry.