Individual provider Active NPI

Kathleen R Everitt, LMSW

  • Clinical Social Worker
  • Walker, MI
National Provider Identifier
1841677895
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801082829 Issued in MI
Practice address
1175 Wilson Ave NW
Walker, MI 49534
Phone
(616) 685-8650
Fax
(616) 791-2160
NPI assigned
Apr 29, 2015
Last updated
Feb 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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 6801082829 MI Primary

Addresses

Primary practice location

1175 Wilson Ave NW
Walker, MI 49534

Mailing address

PO Box 776974
Chicago, IL 60677-6974
Phone (004) 945-7978

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20150514000159 MI Practitioner - Clinical Social Worker 7810217981 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1175 Wilson Ave NW
Walker, MI 49534-6407
Phone (616) 685-8650

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary's Medical Group CurrentSince Jan 22, 2024 Accepting new patients
Mercy Physician Network CurrentSince Jan 22, 2024 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Apr 5, 2015 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients
Advantage Health/Saint Mary's Medical Group CurrentSince Jan 22, 2024 Accepting new patients
Pine Rest Christian Mental Health Services CurrentSince Mar 21, 2016 Accepting new patients
Mercy Physician Network CurrentSince Jan 22, 2024 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Apr 5, 2015 Accepting new patients
Pine Rest Christian Mental Health Services Social Worker CurrentSince Mar 21, 2016 Accepting new patients
Mercy Health Partners - Physician Specialist CurrentSince Jan 22, 2024 Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

2750 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 267-7015

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

1150 E Sherman Blvd
Ste 2400
Muskegon, MI 49444
Phone (231) 672-4243

1500 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3027

2006 Holton Rd
North Muskegon, MI 49445
Phone (231) 672-3333

1150 E Sherman Blvd
Ste 1175
Norton Shores, MI 49444
Phone (231) 672-6740

6050 Northland Dr NE
Ste 200
Rockford, MI 49341
Phone (616) 685-8350

1175 Wilson Ave NW
Walker, MI 49534
Phone (616) 284-3686

300 68th St SE
Wyoming, MI 49548
Phone (616) 455-5000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13864/brand/1/csg/1/fhir/r4

Organizations & group practices 10

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1841677895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776974",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776974",
            "telephone_number": "004-945-7978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 WILSON AVE NW",
            "city": "WALKER",
            "state": "MI",
            "postal_code": "49534",
            "telephone_number": "616-685-8650",
            "fax_number": "616-791-2160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERITT",
        "first_name": "KATHLEEN",
        "middle_name": "R",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-29",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801082829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walker, MI

Sources for this page

Verify at the official NPI Registry.