Individual provider Active NPI

Kathleen H Gernon, LCSW

  • Clinical Social Worker
  • Williamsburg, VA
National Provider Identifier
1770200016
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904014492 Issued in VA
Practice address
501 Prince George St Ste 209
Williamsburg, VA 23185-3664
Phone
(757) 788-1529
NPI assigned
Oct 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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 0904014492 VA Primary

Addresses

Primary practice location

501 Prince George St Ste 209
Williamsburg, VA 23185-3664

Mailing address

501 Prince George St Ste 209
Williamsburg, VA 23185-3664
Phone (757) 788-1529

Other practice location 1

4870 Hickory Signpost Rd
Williamsburg, VA 23185-2406
Phone (757) 788-1529

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20230204000434 VA Practitioner - Clinical Social Worker 5799157533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colonial Behavioral HealthGroup PAC ID 7012010549, 18 clinicians

Practice addresses (Care Compare)

1657 Merrimac TRL
Williamsburg, VA 23185-5624
Phone (757) 220-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Colonial Behavioral Health CurrentSince Jan 23, 2025 Accepting new patients
Colonial Behavioral Health PastSince Jan 23, 2025 Accepting new patients

Locations

1657 Merrimac Trl
Williamsburg, VA 23185
Phone (757) 220-3200

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/2b8c86f5-c497-45b0-94ed-0102e20d1c70/

Organizations & group practices 2

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": "1666828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1770200016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 PRINCE GEORGE ST STE 209",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231853664",
            "telephone_number": "757-788-1529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 PRINCE GEORGE ST STE 209",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231853664",
            "telephone_number": "757-788-1529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4870 Hickory Signpost Rd",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "231852406",
            "country_code": "US",
            "telephone_number": "757-788-1529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GERNON",
        "first_name": "KATHLEEN",
        "middle_name": "H",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-27",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904014492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.