Individual provider Active NPI

Kjerstan Montgomerie Maree Hess

  • Clinical Social Worker
  • Shelbyville, IN
National Provider Identifier
1396571469
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34011430A Issued in IN
Practice address
30 W Rampart Rd
Suite #160
Shelbyville, IN 46176
Phone
(317) 392-2971
NPI assigned
Sep 13, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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 34011430A IN Primary

Addresses

Primary practice location

30 W Rampart Rd
Suite #160
Shelbyville, IN 46176

Mailing address

30 W Rampart Rd
Suite #160
Shelbyville, IN 46176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20241009001972 IN Practitioner - Clinical Social Worker 5395276745 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34011430AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
X-Ray Physicians of Shelbyville PC Current Accepting new patients
Major Multispecialty Associates CurrentSince Sep 17, 2024 Accepting new patients
Major Hospital CurrentSince Sep 17, 2024 Accepting new patients
Major Multispecialty Associates CurrentSince Sep 17, 2024 Accepting new patients
Major Hospital CurrentSince Sep 17, 2024 Accepting new patients

Locations

2451 Intelliplex Dr
Shelbyville, IN 46176
Phone (317) 392-3211

2451 Intelliplex Dr
#210
Shelbyville, IN 46176
Phone (317) 421-1914

2451 Intelliplex Dr
Ste 240
Shelbyville, IN 46176
Phone (317) 398-7337

2325 Intelliplex Dr
Ste 207
Shelbyville, IN 46176
Phone (317) 392-2971

30 W Rampart St
Ste 160
Shelbyville, IN 46176
Phone (317) 392-2161

30 W Rampart St
Ste 200
Shelbyville, IN 46176
Phone (317) 398-0121

Organizations & group practices 5

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": "1726185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1396571469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W RAMPART RD",
            "address_2": "SUITE #160",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "46176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W RAMPART RD",
            "address_2": "SUITE #160",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "46176",
            "telephone_number": "317-392-2971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HESS",
        "first_name": "KJERSTAN",
        "middle_name": "MONTGOMERIE MAREE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-13",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34011430A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, IN

Sources for this page

Verify at the official NPI Registry.