Active NPI
Kellie A Stafford, LSW
- Social Worker
- Owingsville, KY
National Provider Identifier
1508277484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 2271
- Practice address
- 664 Slate Avenue
Owingsville, KY 40360 - Phone
- (606) 674-6690
- Fax
- (606) 674-3005
- NPI assigned
- May 14, 2014
- Last updated
- Nov 7, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 2271 | KY | Primary |
Addresses
Primary practice location
664 Slate Avenue
Owingsville, KY 40360
Mailing address
PO Box 790
Ashland, KY 41105-0790
Phone (606) 329-8588
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30610026 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2271 | KY | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415318400000",
"number": "1508277484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 790",
"city": "ASHLAND",
"state": "KY",
"postal_code": "411050790",
"telephone_number": "606-329-8588",
"fax_number": "606-329-8195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "664 SLATE AVENUE",
"city": "OWINGSVILLE",
"state": "KY",
"postal_code": "40360",
"telephone_number": "606-674-6690",
"fax_number": "606-674-3005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAFFORD",
"first_name": "KELLIE",
"middle_name": "A",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-14",
"last_updated": "2014-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "KY",
"license": "2271",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30610026",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Owingsville, KY
- Amy Snowden
- St Claire Regional Medical Center (St Claire Primary Care Bath Co PH)
- St. Claire Medical Center Dba Bath County Medical Clinic
- St. Claire Medical Center, Inc
- St. Claire Medical Center, Inc (St. Claire Regional Family Medicine-Owingsville)
- Brenna D Stamm
- Tammy Stamper, LCSW
- Sterling Health Solutions Inc (Sterling Health Owingsville Pharmacy)
- Sterling Health Solutions Inc (Sterling Crossroads - Bath)
- Sterling Health Solutions Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.