Individual provider Active NPI

Katherine Kemmerlin, MSW

  • Clinical Social Worker
  • Newburgh, IN
National Provider Identifier
1629504246
Registry record updated May 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
99078196A Issued in IN
Practice address
333 State St
Newburgh, IN 47630-1231
Phone
(812) 773-8321
Fax
(812) 993-1846
NPI assigned
May 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2017

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 99078196A IN Primary

Addresses

Primary practice location

333 State St
Newburgh, IN 47630-1231

Mailing address

333 State St
Newburgh, IN 47630-1231
Phone (812) 773-8321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20201120001957 IN Practitioner - Clinical Social Worker 3971914078 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
99078196AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary'S Medical Group, LLC CurrentSince Nov 1, 2020 Accepting new patients
St Vincent Pediatric Subspecialties Current Accepting new patients
St Mary'S Medical Group, LLC CurrentSince Nov 1, 2020 Accepting new patients
St Vincent Pediatric Subspecialties Clinical CurrentSince Nov 1, 2020 Accepting new patients
Brainpower Neurodevelopmental Center, LLC Clinical Past Accepting new patients

Locations

801 Saint Marys Dr
Ste 505E
Evansville, IN 47714
Phone (812) 491-3236

3900 Washington Ave
#100
Evansville, IN 47714
Phone (317) 871-0000

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331

Interoperability endpoints

  • Direct secure messaging: katherine.kemmerlin.1@7598.direct.athenahealth.com

Organizations & group practices 5

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": "1493683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493683200000",
    "number": "1629504246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 STATE ST",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476301231",
            "telephone_number": "812-773-8321",
            "fax_number": "812-993-1846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 STATE ST",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476301231",
            "telephone_number": "812-773-8321",
            "fax_number": "812-993-1846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMMERLIN",
        "first_name": "KATHERINE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-02",
        "last_updated": "2017-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "99078196A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, IN

Sources for this page

Verify at the official NPI Registry.