Individual provider Active NPI

Kimberly D Denton

  • Clinical Social Worker
  • Rensselaer, IN
National Provider Identifier
1447988720
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
33009523A Issued in IN
Practice address
131 W Drexel Pkwy
Rensselaer, IN 47978-7344
Phone
(219) 866-4194
NPI assigned
Aug 12, 2022
Last updated
Aug 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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 33009523A IN Primary

Addresses

Primary practice location

131 W Drexel Pkwy
Rensselaer, IN 47978-7344

Mailing address

301 S Milton St
Rensselaer, IN 47978-2966
Phone (219) 863-6854

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
I20220908003529 IN Practitioner - Clinical Social Worker 5890179964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Oaks Health IncGroup PAC ID 7315927563, 45 clinicians

Practice addresses (Care Compare)

415 N 26TH St
Lafayette, IN 47904-2895
Phone (765) 446-6549

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33009523AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Oaks Health Inc CurrentSince Jul 12, 2022 Accepting new patients
Valley Oaks Health Inc CurrentSince Jul 12, 2022 Accepting new patients

Locations

415 N 26th St
Lafayette, IN 47904
Phone (765) 446-6400

415 N 26th St
Ste 201
Lafayette, IN 47904
Phone (765) 446-6535

610 Main St
Lafayette, IN 47901
Phone (765) 423-2638

131 W Drexel Pkwy
Rensselaer, IN 47978
Phone (219) 866-4194

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1447988720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S MILTON ST",
            "city": "RENSSELAER",
            "state": "IN",
            "postal_code": "479782966",
            "telephone_number": "219-863-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 W DREXEL PKWY",
            "city": "RENSSELAER",
            "state": "IN",
            "postal_code": "479787344",
            "telephone_number": "219-866-4194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENTON",
        "first_name": "KIMBERLY",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "33009523A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rensselaer, IN

Sources for this page

Verify at the official NPI Registry.