John J Kish III, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34004560A Issued in IN

Practice address

3660 Rome Dr
Lafayette, IN 47905-4488

Phone

(765) 446-9394

Fax

(765) 447-8875

NPI assigned

Aug 29, 2006

Last updated

Apr 8, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2018 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Alpine Physicians, LLC

  • Psychiatry Physician
  • Lafayette, IN
  • NPI 1225554801
  NPD (past)
• Emerald Neuro-Recover

  • Family Medicine Physician
  • Carmel, IN
  • NPI 1508334814
  NPD (past)
• Harmony Counseling Center, LLC

  • Clinical Social Worker
  • Lafayette, IN
  • NPI 1265820393
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396915200000",
    "number": "1790894517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2493 GALA CT",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "47906",
            "telephone_number": "765-446-9394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 ROME DR",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054488",
            "telephone_number": "765-446-9394",
            "fax_number": "765-447-8875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISH",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_suffix": "III",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2014-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004560A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Polly King, CPSP
• Tammie Anne King, PHARM.D.
• Kristen F Kirby, DNP, FNP-BC, CNE
• Jeffrey Edmund Kirchner, O.D.
• David James Kiser, PHD
• Julie Kitchell
• Kiara Kizer, RBT
• Tracy Kleber, D.C
• Meryl Klein
• Emilee Klemme, R.PH

• Clinical Social Worker in Lafayette, IN
• Providers in Lafayette, 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 Apr 8, 2014; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.