Individual provider Active NPI

Kelly Marie Bunker, LISW

  • Clinical Social Worker
  • Cincinnati, OH
National Provider Identifier
1427288703
Registry record updated Jun 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0008269-SUPV Issued in OH
Practice address
3333 Burnet Avenue
ML 3014
Cincinnati, OH 45229-3039
Phone
(513) 636-4225
Fax
(513) 636-2511
NPI assigned
Jul 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2015

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 I.0008269-SUPV OH Primary

Addresses

Primary practice location

3333 Burnet Avenue
ML 3014
Cincinnati, OH 45229-3039

Mailing address

3333 Burnet Avenue
ML 3014
Cincinnati, OH 45229-3039
Phone (513) 636-4225

Other names 1

  • Kelly Marie Malloy Kuhn Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20091130000307 OH Practitioner - Clinical Social Worker 9638218951 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.0008269-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lindner Center of Hope Professional Associates Clinical CurrentSince Jun 14, 2022 Accepting new patients
The Craig and Frances Lindner Center of Hope CurrentSince Jun 14, 2022 Accepting new patients

Locations

4075 Old Western Row Rd
Mason, OH 45040
Phone (513) 536-0232

Interoperability endpoints

  • Direct secure messaging: kbunker442068@direct.uchealth.com

Organizations & group practices 2

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": "1248134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434499200000",
    "number": "1427288703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVENUE",
            "address_2": "ML 3014",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293039",
            "telephone_number": "513-636-4225",
            "fax_number": "513-636-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVENUE",
            "address_2": "ML 3014",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293039",
            "telephone_number": "513-636-4225",
            "fax_number": "513-636-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNKER",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-21",
        "last_updated": "2015-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0008269-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "MALLOY KUHN",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.