Individual provider Active NPI

Kendra J. Cole, LCSW

  • Clinical Social Worker
  • Charleston, IL
National Provider Identifier
1548352248
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-007401 Issued in IL
Practice address
700 W Lincoln Ave Ste 200
Charleston, IL 61920-2468
Phone
(217) 238-4042
Fax
(217) 238-4053
NPI assigned
Sep 29, 2006
Last updated
Sep 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 149007401 IL
Clinical Social Worker 1041C0700X 149-007401 IL Primary

Addresses

Primary practice location

700 W Lincoln Ave Ste 200
Charleston, IL 61920-2468

Mailing address

PO Box 372
Mattoon, IL 61938-0372
Phone (217) 258-2581

Other practice location 1

1004 Health Center Dr Ste 210
Mattoon, IL 61938-4608
Phone (217) 348-4961

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20051121000302 IL Practitioner - Clinical Social Worker 4486673324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sarah Bush Lincoln Health CenterGroup PAC ID 5092614867, 411 clinicians

Practice addresses (Care Compare)

1005 Health Ctr Dr
Suite 102
Mattoon, IL 61938-4637
Phone (217) 258-4042

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as apm
Quality
69.5
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-007401ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sarah Bush Lincoln Health Center CurrentSince Sep 15, 2024 Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince Oct 20, 2005 Accepting new patients

Locations

700 W Lincoln Ave
Ste 200
Charleston, IL 61920
Phone (217) 238-4866

1000 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2389

1004 Health Center Dr
Ste 210
Mattoon, IL 61938
Phone (217) 238-4961

1005 Health Center Dr
Ste 101
Mattoon, IL 61938
Phone (217) 238-4774

1005 Health Center Dr
Ste 102
Mattoon, IL 61938
Phone 21734234002414

1005 Health Center Dr
Ste 201
Mattoon, IL 61938
Phone (217) 238-6055

101 Professional Plz
Mattoon, IL 61938
Phone (217) 238-3730

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1548352248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 372",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619380372",
            "telephone_number": "217-258-2581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W LINCOLN AVE STE 200",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619202468",
            "telephone_number": "217-238-4042",
            "fax_number": "217-238-4053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1004 Health Center Dr Ste 210",
            "address_purpose": "LOCATION",
            "city": "Mattoon",
            "state": "IL",
            "postal_code": "619384608",
            "country_code": "US",
            "telephone_number": "217-348-4961",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLE",
        "first_name": "KENDRA",
        "middle_name": "J.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "149007401",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-007401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, IL

Sources for this page

Verify at the official NPI Registry.