Individual provider Active NPI

Kerri A. McAvay-Redner, LCSW

  • Clinical Social Worker
  • Norwich, CT
National Provider Identifier
1447459698
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
006491 Issued in CT
Practice address
8 Mahan Dr
Norwich, CT 06360-2426
Phone
(860) 934-5123
NPI assigned
Jul 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 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 006491 CT Primary

Addresses

Primary practice location

8 Mahan Dr
Norwich, CT 06360-2426

Mailing address

206 McKinley Avenue Ext
Norwich, CT 06360-3536
Phone (860) 934-5123

Other practice location 1

206 McKinley Avenue Ext
Norwich, CT 06360-3536
Phone (860) 934-5123

Other identifiers 2

IdentifierTypeStateIssuer
006491OtherCTCONNECTICUT LICENSED CLIN
004271425MedicaidCT

Other names 1

  • Kerri McAvay Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20070829000528 CT Practitioner - Clinical Social Worker 7012000532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8 Mahan Dr
Norwich, CT 06360-2426
Phone (860) 934-5123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006491CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas H. Walter DPM, Inc. PastSince Dec 8, 2024 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12934/brand/1/csg/1/fhir/r4

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": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1447459698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 MCKINLEY AVENUE EXT",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063603536",
            "telephone_number": "860-934-5123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 MAHAN DR",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602426",
            "telephone_number": "860-934-5123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "206 McKinley Avenue Ext",
            "address_purpose": "LOCATION",
            "city": "Norwich",
            "state": "CT",
            "postal_code": "063603536",
            "country_code": "US",
            "telephone_number": "860-934-5123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCAVAY-REDNER",
        "first_name": "KERRI",
        "middle_name": "A.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICUT LICENSED CLIN",
            "identifier": "006491",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004271425",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERRI",
            "last_name": "MCAVAY",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Norwich, CT

Sources for this page

Verify at the official NPI Registry.