Active NPI
Karen Brady Dudgeon, LCSW
- Clinical Social Worker
- Cortland, NY
National Provider Identifier
1821076894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 074330-1
- Practice address
- 17-29 Main St 420
Cortland, NY 13045 - Phone
- (607) 527-0575
- Fax
- (888) 927-1815
- NPI assigned
- Jan 9, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 074330-1 | NY | Primary |
Addresses
Primary practice location
17-29 Main St 420
Cortland, NY 13045
Mailing address
17-29 Main St 420
Cortland, NY 13045
Phone (607) 527-0575
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151120000430 | NY | Practitioner - Clinical Social Worker | 6204136468 | Practice locations: Cortland, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
17 -29 Main St
Suite 420
Cortland, NY 13045-2676
Phone (617) 527-0575
17 -29 Main St McNeil Building
Suite 420
Cortland, NY 13045-2001
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 074330-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444953600000",
"number": "1821076894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17-29 MAIN ST 420",
"city": "CORTLAND",
"state": "NY",
"postal_code": "13045",
"telephone_number": "607-527-0575",
"fax_number": "888-972-1815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17-29 MAIN ST 420",
"city": "CORTLAND",
"state": "NY",
"postal_code": "13045",
"telephone_number": "607-527-0575",
"fax_number": "888-927-1815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUDGEON",
"first_name": "KAREN",
"middle_name": "BRADY",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-09",
"last_updated": "2015-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "074330-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cortland, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; 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.