Organization Active NPI

KGS LCSW

  • Clinical Social Worker
  • Ashland, OR
National Provider Identifier
1366974347
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
KGS LCSW
Practice address
1983 Tamarack PL
Ashland, OR 97520-3542
Phone
(541) 821-2596
Fax
(541) 488-7897
NPI assigned
Mar 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Authorized official

Name
Kristina G Schweikert, LCSWNPI 1154605228
Title
Sole Member
Phone
(541) 821-2596

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1983 Tamarack PL
Ashland, OR 97520-3542

Mailing address

PO Box 1426
Talent, OR 97540-1426
Phone (541) 821-2596

Other practice location 1

1611 E Barnett Rd
Medford, OR 97504-8284
Phone (541) 821-2596

Other identifiers 1

IdentifierTypeStateIssuer
500689907MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170407001973 OR Part B Supplier - Clinic/Group Practice 5799061636 Receives reassigned benefits from 1 practitioner
Practice locations: Medford, OR

National Provider Directory

National Provider Directory

Locations

843 E Main St
Ste 304
Medford, OR 97504
Phone (541) 821-2596

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724716800000",
    "number": "1366974347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1426",
            "city": "TALENT",
            "state": "OR",
            "postal_code": "975401426",
            "telephone_number": "541-821-2596",
            "fax_number": "541-488-7897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1983 TAMARACK PL",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975203542",
            "telephone_number": "541-821-2596",
            "fax_number": "541-488-7897"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 E Barnett Rd",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975048284",
            "country_code": "US",
            "telephone_number": "541-821-2596",
            "fax_number": "541-488-7897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KGS LCSW",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-30",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A",
        "authorized_official_last_name": "SCHWEIKERT",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "541-821-2596",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500689907",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.