Individual provider Active NPI

Kean Baxter, MSW

  • Clinical Social Worker
  • Washington, DC
National Provider Identifier
1831543719
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC50080816 Issued in DC
Practice address
445 Mellon St SE
Washington, DC 20032-2642
Phone
(202) 751-6444
NPI assigned
Apr 18, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC50080816 DC Primary
Clinical Social Worker 1041C0700X 18972 MD

Addresses

Primary practice location

445 Mellon St SE
Washington, DC 20032-2642

Mailing address

445 Mellon St SE
Washington, DC 20032-2642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20180521000229 DC Practitioner - Clinical Social Worker 3779848882 Reassigns benefits to 4 organizations
Practice locations: Upper Marlboro, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
United Family Mission IncorporationGroup PAC ID 7416317730, 2 clinicians

Practice addresses (Care Compare)

8700 Central Ave
Suite 300
Landover, MD 20785-4853
Phone (240) 708-6529

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC50080816DCMDClinical Social Worker
18972MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mbi Health Services LLC CurrentSince May 1, 2018 Accepting new patients
United Family Mission Incorporation CurrentSince Jun 19, 2023 Accepting new patients
Wellness Healthcare Clinics. LLC CurrentSince Mar 1, 2021 Accepting new patients
The Soul Remediation Center LLC Clinical PastSince Dec 1, 2024 Accepting new patients

Locations

4660 Martin Luther King Jr Ave SW
Ste A3
Washington, DC 20032
Phone (202) 318-0179

4130 Hunt Pl NE
Washington, DC 20019
Phone (202) 388-4320

7200 Wisconsin Ave
Ste 702
Bethesda, MD 20814
Phone (202) 215-5348

8700 Central Ave
Ste 300
Landover, MD 20785
Phone (240) 708-6529

8700 Central Ave
Ste 200
Landover, MD 20785
Phone (240) 708-6529

Organizations & group practices 5

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": "1460937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1831543719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 MELLON ST SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200322642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 MELLON ST SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200322642",
            "telephone_number": "202-751-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAXTER",
        "first_name": "KEAN",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-18",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50080816",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "18972",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.