Individual provider Active NPI

Robert C Kinnear, LCSW

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1881638815
Registry record updated Apr 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34001642A Issued in IN
Practice address
9510 Prospect St
Indianapolis, IN 46239-9639
Phone
(317) 898-7446
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39001098A IN
Clinical Social Worker 1041C0700X 34001642A IN Primary
Marriage & Family Therapist 106H00000X 35000874A IN
Registered Nurse 163W00000X 28169390A IN

Addresses

Primary practice location

9510 Prospect St
Indianapolis, IN 46239-9639

Mailing address

9510 Prospect St
Indianapolis, IN 46239-9639
Phone (317) 898-7446

Other identifiers 1

IdentifierTypeStateIssuer
200042460MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39001098AINMDMental Health Counselor
35000874AINMDMarriage & Family Therapist
28169390AINMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Hospital & Health Care Center, Inc. Past Accepting new patients
St. Vincent Hospital & Health Care Center, Inc. Marriage & Family Therapist PastSince Mar 1, 2010 Accepting new patients

Organizations & group practices 2

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459814400000",
    "number": "1881638815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9510 PROSPECT ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462399639",
            "telephone_number": "317-898-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9510 PROSPECT ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462399639",
            "telephone_number": "317-898-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNEAR",
        "first_name": "ROBERT",
        "middle_name": "C",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2016-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39001098A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34001642A",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35000874A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28169390A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200042460",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.