Individual provider Active NPI

Kimberly Sanders

  • Social Worker
  • Athens, OH
National Provider Identifier
1619461159
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
11 Graham Dr
Athens, OH 45701-1430
Phone
(800) 321-8293
NPI assigned
Jun 18, 2018
Last updated
Sep 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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 NU Primary
Community Health Worker 172V00000X NU

Addresses

Primary practice location

11 Graham Dr
Athens, OH 45701-1430

Mailing address

PO Box 1595
Columbus, OH 43216-1595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20191114001779 OH Practitioner - Clinical Social Worker 1850723750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Services for Behavioral HealthGroup PAC ID 9234372525, 39 clinicians

Practice addresses (Care Compare)

1206 W Broad St
Columbus, OH 43222-1319
Phone (800) 321-8293

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Services for Behavioral Health CurrentSince Sep 15, 2019 Accepting new patients
Integrated Services for Behavioral Health Past Accepting new patients

Locations

11 Graham Dr
Athens, OH 45701
Phone (740) 594-6807

1206 W Broad St
Columbus, OH 43222
Phone (614) 869-0054

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/isaoh/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1619461159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1595",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432161595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 GRAHAM DR",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457011430",
            "telephone_number": "800-321-8293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, OH

Sources for this page

Verify at the official NPI Registry.