Individual provider Active NPI

Karin Fodness, LCSW

  • Specialist
  • Missoula, MT
National Provider Identifier
1699838193
Registry record updated Sep 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
726-LCSW Issued in MT
Practice address
235 N 1St St W
Ste C
Missoula, MT 59802-3661
Phone
(406) 721-7690
Fax
(406) 541-6567
NPI assigned
Dec 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 726-LCSW MT
Specialist 174400000X 726-LCSW MT Primary

Addresses

Primary practice location

235 N 1St St W
Ste C
Missoula, MT 59802-3661

Mailing address

235 N 1St St W
Ste C
Missoula, MT 59802-3661
Phone (406) 396-2762

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20140219001363 MT Practitioner - Clinical Social Worker 7214166107 Practice locations: Missoula, MT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

235 N 1St St W
Suite C
Missoula, MT 59802-3661
Phone (406) 396-2762

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
726-LCSWMTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey Ashmore PLLC Clinical Past Accepting new patients

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": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537660800000",
    "number": "1699838193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 N 1ST ST W",
            "address_2": "STE C",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598023661",
            "telephone_number": "406-396-2762",
            "fax_number": "406-728-5178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 N 1ST ST W",
            "address_2": "STE C",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598023661",
            "telephone_number": "406-721-7690",
            "fax_number": "406-541-6567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FODNESS",
        "first_name": "KARIN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2018-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "726-LCSW",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MT",
            "license": "726-LCSW",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.