Individual provider Active NPI

Karlee Keiper, LCSW

  • Clinical Social Worker
  • Mishawaka, IN
National Provider Identifier
1861045163
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34009228A Issued in IN
Practice address
1818 Went Ave Ste a
Mishawaka, IN 46545-6482
Phone
(574) 254-0229
Fax
(574) 254-0188
NPI assigned
Jul 17, 2019
Last updated
Apr 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 33008166A IN
Clinical Social Worker 1041C0700X 34009228A IN Primary

Addresses

Primary practice location

1818 Went Ave Ste a
Mishawaka, IN 46545-6482

Mailing address

240 N Tillotson Ave
Muncie, IN 47304-3988
Phone (765) 288-1928

Other identifiers 2

IdentifierTypeStateIssuer
33008166AOtherINSOCIAL WORKER LICENSE
14503865OtherCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20210421000795 IN Practitioner - Clinical Social Worker 3375951908 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meridian Health Services CorpGroup PAC ID 5597679845, 78 clinicians

Practice addresses (Care Compare)

1818 Went Ave
Suite a
Mishawaka, IN 46545-6482
Phone (765) 288-1928

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33008166AINMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Health Services Corp. CurrentSince Apr 5, 2021 Accepting new patients
Meridian Health Services Corp CurrentSince Apr 5, 2021 Accepting new patients
Meridian Health Services Corp. Past Accepting new patients

Locations

422 Franklin St
Ste F
Michigan City, IN 46360

1818 Went Ave
Ste A
Mishawaka, IN 46545
Phone (574) 254-0229

240 N Tillotson Ave
Muncie, IN 47304

Interoperability endpoints

  • Direct secure messaging: karlee.keiper.p1@direct.meridianhs.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1861045163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N TILLOTSON AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043988",
            "telephone_number": "765-288-1928",
            "fax_number": "765-741-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 WENT AVE STE A",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465456482",
            "telephone_number": "574-254-0229",
            "fax_number": "574-254-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEIPER",
        "first_name": "KARLEE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-17",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33008166A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34009228A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORKER LICENSE",
            "identifier": "33008166A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14503865",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.