Individual provider Active NPI

Holly A Kern

  • Social Worker
  • Fishers, IN
National Provider Identifier
1699559906
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
99116107A Issued in IN
Practice address
13341 Fielding Way
Fishers, IN 46037-4612
Phone
(317) 735-5535
NPI assigned
Aug 21, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 99116107A IN Primary

Addresses

Primary practice location

13341 Fielding Way
Fishers, IN 46037-4612

Mailing address

13341 Fielding Way
Fishers, IN 46037-4612
Phone (317) 735-5535

Other practice location 1

1041 Shelby St
Indianapolis, IN 46203-1153
Phone (317) 735-5355

Other practice location 2

6038 N Keystone Ave
Indianapolis, IN 46220-2590
Phone (317) 735-5355

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
99116107AINMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1699559906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13341 FIELDING WAY",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460374612",
            "telephone_number": "317-735-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13341 FIELDING WAY",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460374612",
            "telephone_number": "317-735-5535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1041 Shelby St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462031153",
            "country_code": "US",
            "telephone_number": "317-735-5355",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6038 N Keystone Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462202590",
            "country_code": "US",
            "telephone_number": "317-735-5355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KERN",
        "first_name": "HOLLY",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "99116107A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.