Active NPI
Kathleen H Gernon, LCSW
- Clinical Social Worker
- Williamsburg, VA
National Provider Identifier
1770200016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904014492
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Colonial Behavioral Health | Current | Accepting new patients | |
| Colonial Behavioral Health | Past | Accepting new patients |
Locations
1657 Merrimac Trl
Williamsburg, VA 23185
Phone (757) 220-3200
Interoperability endpoints
- 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.
-
- Community/Behavioral Health Agency
- Williamsburg, VA
- NPI 1760565915
-
- Health Maintenance Organization
- Williamsburg, VA
- NPI 1841556776
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.