Individual provider Active NPI

Katrina L Porter, LSCSW

  • Clinical Social Worker
  • Lawrence, KS
National Provider Identifier
1639289200
Registry record updated Aug 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3622 Issued in KS
Practice address
900 Massachusetts St
Suite #408
Lawrence, KS 66044-2868
Phone
(785) 220-5690
Fax
(785) 864-0014
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2013

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 3622 KS Primary

Addresses

Primary practice location

900 Massachusetts St
Suite #408
Lawrence, KS 66044-2868

Mailing address

900 Massachusetts St
Suite #408
Lawrence, KS 66044-2868
Phone (785) 220-5690

Other identifiers 2

IdentifierTypeStateIssuer
200631120AMedicaidKS
P00655165OtherKSRR MEDICARE

Other names 1

  • Katrina L Foley Former 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
I20061002000494 KS Practitioner - Clinical Social Worker 4587669254 Reassigns benefits to 1 organization
Practice locations: Lawrence, KS

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

900 Massachusetts St
Suite 408
Lawrence, KS 66044-6001
Phone (785) 220-5690

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3622KSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Prime TMS LLC CurrentSince May 11, 2022 Accepting new patients

Locations

1811 Wakarusa Dr
Ste 102
Lawrence, KS 66047
Phone (785) 371-4921

1725 SW Gage Blvd
Ste 201
Topeka, KS 66604
Phone (785) 371-4921

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375747200000",
    "number": "1639289200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MASSACHUSETTS ST",
            "address_2": "SUITE #408",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660442868",
            "telephone_number": "785-220-5690",
            "fax_number": "785-864-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MASSACHUSETTS ST",
            "address_2": "SUITE #408",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660442868",
            "telephone_number": "785-220-5690",
            "fax_number": "785-864-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "KATRINA",
        "middle_name": "L",
        "credential": "LSCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "3622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200631120A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00655165",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATRINA",
            "last_name": "FOLEY",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lawrence, KS

Sources for this page

Verify at the official NPI Registry.