Individual provider Active NPI

Keith Bryant Rigby, MSW

  • Clinical Social Worker
  • Crescent City, CA
National Provider Identifier
1497189146
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
150 Creekside LN
Crescent City, CA 95531-8679
Phone
(541) 941-4209
Fax
(707) 238-6461
NPI assigned
Aug 29, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 96933 CA
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

150 Creekside LN
Crescent City, CA 95531-8679

Mailing address

150 Creekside LN
Crescent City, CA 95531-8679
Phone (541) 941-4209

Other practice location 1

331 SE 2nd St
Pendleton, OR 97801-2224
Phone (541) 276-6207

Other names 1

  • Keith Bryant Rigby Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20210118000165 CA Practitioner - Clinical Social Worker 6800209693 Practice locations: Crescent City, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

150 Creekside LN
Crescent City, CA 95531-8679
Phone (541) 941-4209

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
96933CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1377734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1497189146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 CREEKSIDE LN",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955318679",
            "telephone_number": "541-941-4209",
            "fax_number": "707-238-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 CREEKSIDE LN",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955318679",
            "telephone_number": "541-941-4209",
            "fax_number": "707-238-6461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "331 SE 2nd St",
            "address_purpose": "LOCATION",
            "city": "Pendleton",
            "state": "OR",
            "postal_code": "978012224",
            "country_code": "US",
            "telephone_number": "541-276-6207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIGBY",
        "first_name": "KEITH",
        "middle_name": "BRYANT",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-29",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "96933",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEITH",
            "last_name": "RIGBY",
            "middle_name": "BRYANT",
            "credential": "MSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Crescent City, CA

Sources for this page

Verify at the official NPI Registry.