Individual provider Active NPI

Carie Elizabeth Brown, MSW LSCSW

  • Clinical Social Worker
  • Great Bend, KS
National Provider Identifier
1629196605
Registry record updated Nov 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3716 Issued in KS
Practice address
1905 19TH St
Great Bend, KS 67530-2502
Phone
(620) 792-2544
Fax
(620) 792-7052
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2008

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 5375
Clinical Social Worker 1041C0700X 3716 KS Primary

Addresses

Primary practice location

1905 19TH St
Great Bend, KS 67530-2502

Mailing address

1905 19TH St
Great Bend, KS 67530-2502
Phone (620) 792-2544

Other identifiers 1

IdentifierTypeStateIssuer
100098090AMedicaidKS

Other names 1

  • Ms. Carie Elizabeth Rust Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20081103000113 KS Practitioner - Clinical Social Worker 7618036880 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3716KSMDClinical Social Worker

Interoperability endpoints

  • Direct secure messaging: carie.brown@khindirect.org
  • Direct secure messaging: carie.brown.1@20094.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226966400000",
    "number": "1629196605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 19TH ST",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675302502",
            "telephone_number": "620-792-2544",
            "fax_number": "620-792-7052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 19TH ST",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675302502",
            "telephone_number": "620-792-2544",
            "fax_number": "620-792-7052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CARIE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "MSW LSCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2008-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": "5375",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "3716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100098090A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARIE",
            "last_name": "RUST",
            "middle_name": "ELIZABETH",
            "prefix": "MS.",
            "credential": "LMSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Great Bend, KS

Sources for this page

Verify at the official NPI Registry.