Kristen Kaye Fuquay, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34004225A Issued in IN

Practice address

6950 Hillsdale CT
Indianapolis, IN 46250-2040

Phone

(317) 621-7740

NPI assigned

Apr 4, 2007

Last updated

Nov 9, 2020By the provider in NPPES

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: No
• 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

• Direct secure messaging: kfuquay7653@ecommunitydirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Health Network, Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1336119478
  Medicare reassignment NPD
• Community Health Network, Inc

  dba Community Fairbanks Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Indianapolis, IN
  • NPI 1265477632
  NPD
• Community Health Network, Inc

  dba Community Behavioral Professionals

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Indianapolis, IN
  • NPI 1922336262
  NPD (past)

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1790807303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH STREET",
            "address_2": "SUITE 230",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890",
            "telephone_number": "317-621-7561",
            "fax_number": "317-355-6096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6950 HILLSDALE CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502040",
            "telephone_number": "317-621-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUQUAY",
        "first_name": "KRISTEN",
        "middle_name": "KAYE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004225A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100270530A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KFUQUAY7653@ECOMMUNITYDIRECT.COM",
            "affiliation": "N",
            "address_1": "6950 Hillsdale Ct",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462502040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ella Louise Funke, CAA
• Allison Ann Funkhouser, MA, BCBA
• Kiarra Funnell
• John S. Fuqua, MD
• Monika Fuqua, MHC
• Robert Brent Furbee, M.D.
• Alvin J Furiya, RD
• Kirstin Furlong, PHARMD
• Kaneisa M Furlow
• Patricia Furner

• Clinical Social Worker in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.