Kelsi Lynn Dobson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149020183 Issued in IL

Practice address

1600 W Walnut St
Jacksonville, IL 62650-1136

Phone

(217) 245-9541

NPI assigned

Nov 26, 2018

Last updated

Nov 26, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Memorial Medical Center

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1033171343
  Medicare reassignment NPD
• Memorial Medical Center

  dba The Hearing Center at Memorial

  • Audiologist
  • Springfield, IL
  • NPI 1679549968
  NPD

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543190400000",
    "number": "1366912040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W WALNUT ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501136",
            "telephone_number": "217-245-9541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W WALNUT ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501136",
            "telephone_number": "217-245-9541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBSON",
        "first_name": "KELSI",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-26",
        "last_updated": "2018-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149020183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL DEPT. OF FINANCIAL & PROFESSIONAL REGULATIONS",
            "identifier": "149020183",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachael Renee Dean, DTV
• Jozy Degroot, HIS
• Department of Human Services
• Caitlen Elizabeth Despain, FNP-BC
• Kristi A. Diblasi, PHARMD
• Mark Stephen Dolz, DO
• Sarah Elizabeth Donegan, PCET M.ED.
• Dennis A Doyle, DC
• Edwin S Doyle, D.C.
• Kelly Irvin Doyle, D.C.

• Clinical Social Worker in Jacksonville, IL
• Providers in Jacksonville, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.