Individual provider Active NPI

Kelsey Paige Gossett, LCSW

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1558132266
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34006050A Issued in IN
Practice address
1801 Senate Blvd
Indianapolis, IN 46202-1228
Phone
(317) 944-3889
Fax
(317) 944-3882
NPI assigned
Jan 11, 2024
Last updated
Jan 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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 34006050A IN Primary

Addresses

Primary practice location

1801 Senate Blvd
Indianapolis, IN 46202-1228

Mailing address

PO Box 778912
Chicago, IL 60677-8912
Phone (317) 777-6435

Other identifiers 1

IdentifierTypeStateIssuer
300085836MedicaidIN

Other names 1

  • Kelsey Paige Overpeck Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
34006050AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatric Associates, Inc. CurrentSince Jan 21, 2024 Accepting new patients

Locations

1801 Senate Blvd
Indianapolis, IN 46202
Phone (317) 929-8880

8820 S Meridian St
Indianapolis, IN 46217
Phone (317) 865-6690

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, 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": "1704931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1558132266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 778912",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606778912",
            "telephone_number": "317-777-6435",
            "fax_number": "317-777-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 SENATE BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021228",
            "telephone_number": "317-944-3889",
            "fax_number": "317-944-3882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSSETT",
        "first_name": "KELSEY",
        "middle_name": "PAIGE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-11",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006050A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300085836",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "OVERPECK",
            "middle_name": "PAIGE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.