Individual provider Active NPI

Kelly Zachary, LCSW

  • Clinical Social Worker
  • Nashville, TN
National Provider Identifier
1487063293
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7002 Issued in TN
Practice address
275 Cumberland BND
Nashville, TN 37228-1805
Phone
(866) 816-0433
Fax
(615) 743-1679
NPI assigned
Aug 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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 7002 TN Primary

Addresses

Primary practice location

275 Cumberland BND
Nashville, TN 37228-1805

Mailing address

275 Cumberland BND
Nashville, TN 37228-1805
Phone (615) 726-3340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20200122002941 TN Practitioner - Clinical Social Worker 7012342967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mental Health Cooperative, IncGroup PAC ID 5496798399, 47 clinicians

Practice addresses (Care Compare)

275 Cumberland BND
Nashville, TN 37228-1805
Phone (866) 816-0433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7002TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Cooperative, Inc CurrentSince Dec 3, 2019 Accepting new patients

Locations

1632 Gateway Blvd
Murfreesboro, TN 37129
Phone (615) 904-6490

275 Cumberland Bnd
Nashville, TN 37228
Phone (615) 726-3340

Organizations & group practices 1

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": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1487063293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 CUMBERLAND BND",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372281805",
            "telephone_number": "615-726-3340",
            "fax_number": "615-743-1679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 CUMBERLAND BND",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372281805",
            "telephone_number": "866-816-0433",
            "fax_number": "615-743-1679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHARY",
        "first_name": "KELLY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-05",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "7002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.