Individual provider Active NPI

Kelsey Reuter, LCSW

  • Clinical Social Worker
  • Dixon, IL
National Provider Identifier
1790459790
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.023480 Issued in IL
Practice address
628 Reynoldswood Rd
Dixon, IL 61021-9108
Phone
(608) 289-7239
NPI assigned
Aug 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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 149.023480 IL Primary

Addresses

Primary practice location

628 Reynoldswood Rd
Dixon, IL 61021-9108

Mailing address

628 Reynoldswood Rd
Dixon, IL 61021-9108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20211203000975 IL Practitioner - Clinical Social Worker 0345630422 Reassigns benefits to 3 organizations

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
Reuter Counseling PLLCGroup PAC ID 0042658114, 2 clinicians

Practice addresses (Care Compare)

1254 N Galena Ave
Suite B
Dixon, IL 61021-1056
Phone (815) 285-5862

Merit-based Incentive Payment System (MIPS)

Final score
82.78 of 100Reported as group
Quality
60.49
Promoting interoperability
100
Improvement activities
40
Cost
77.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.023480ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
KSB Medical Group, Inc. CurrentSince Oct 27, 2021 Accepting new patients
Roberts Counseling, PLLC Clinical CurrentSince Mar 21, 2023 Accepting new patients
Reuter Counseling, PLLC CurrentSince Feb 19, 2024 Accepting new patients
KSB Medical Group, Inc. CurrentSince Oct 27, 2021 Accepting new patients

Locations

1254 N Galena Ave
Ste B
Dixon, IL 61021
Phone (815) 277-9820

215 E 1st St
Ste 111
Dixon, IL 61021
Phone (815) 285-5477

403 E 1st St
Dixon, IL 61021
Phone (815) 285-5629

114 E Everett St
Ste 209
Dixon, IL 61021
Phone (563) 293-6917

215 E 1st St
Ste 117
Dixon, IL 61021
Phone (815) 285-5900

Organizations & group practices 4

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": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1790459790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 REYNOLDSWOOD RD",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610219108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 REYNOLDSWOOD RD",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610219108",
            "telephone_number": "608-289-7239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REUTER",
        "first_name": "KELSEY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-03",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.023480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dixon, IL

Sources for this page

Verify at the official NPI Registry.