Active NPI
Kehly Ann Stone, LCSW
- Clinical Social Worker
- Canon City, CO
National Provider Identifier
1366801979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW.09925398
- Practice address
- 1335 Phay Ave
Ste B
Canon City, CO 81212 - Phone
- (719) 445-6689
- Fax
- (719) 372-8281
- NPI assigned
- Feb 11, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW.09925398 | CO | Primary |
Addresses
Primary practice location
1335 Phay Ave
Ste B
Canon City, CO 81212
Mailing address
1335 Phay Ave
Ste B
Canon City, CO 81212
Phone (719) 429-7528
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14378751 | Other | CO | CAQH |
| 9000163735 | Medicaid | CO |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200224000056 | CO | Practitioner - Clinical Social Worker | 0941637458 | Practice locations: Canon City, CO; Lamar, CO; Florence, CO |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1335 Phay Ave
Suite B
Canon City, CO 81212-2349
Phone (719) 445-6689
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": "1455148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707868800000",
"number": "1366801979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1335 PHAY AVE",
"address_2": "STE B",
"city": "CANON CITY",
"state": "CO",
"postal_code": "81212",
"telephone_number": "719-429-7528",
"fax_number": "719-372-8281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1335 PHAY AVE",
"address_2": "STE B",
"city": "CANON CITY",
"state": "CO",
"postal_code": "81212",
"telephone_number": "719-445-6689",
"fax_number": "719-372-8281"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STONE",
"first_name": "KEHLY",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-11",
"last_updated": "2024-02-14",
"certification_date": "2024-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "CSW.09925398",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "14378751",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9000163735",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Canon City, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.