Kellie Lyn Rae, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7839 Issued in OH

Practice address

5743 Forest Elm LN Apt B
Columbus, OH 43229-3753

Phone

(614) 582-9374

NPI assigned

Jul 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/northcommunity/r4/

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.

• Netcare Corporation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Columbujs, OH
  • NPI 1346207503
  Medicare reassignment NPD
• North Community Counseling Centers Inc

  • Clinic/Center
  • Columbus, OH
  • NPI 1003085648
  Medicare reassignment NPD

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373932800000",
    "number": "1700076817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5743 FOREST ELM LN APT B",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432293753",
            "telephone_number": "614-582-9374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5743 FOREST ELM LN APT B",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432293753",
            "telephone_number": "614-582-9374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAE",
        "first_name": "KELLIE",
        "middle_name": "LYN",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-26",
        "last_updated": "2013-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "7839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michal Radomski, MD
• Suzana Radovanovic, LPN
• Steven M. Radwany, MD
• Emily Rady
• Nibras Rady, RN
• Bradley Dennis Raetzke, MD
• Julia Raffa, QMHS BA CMS
• Amber Raffeld, MFTT BA
• Kirsten Markiea Rafiq
• Mussarat Rafiq, CNP

• Clinical Social Worker in Columbus, OH
• Providers in Columbus, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.