Kimberly Dawn Eldridge

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149020404 Issued in IL

Practice address

1120 E Main St Ste 201
St Charles, IL 60174-2287

Phone

(630) 377-6613

Fax

(630) 377-6225

NPI assigned

Aug 13, 2018

Last updated

Aug 13, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Auxilium Psychological Services LLCGroup PAC ID 4082057823, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Auxilium Psychological Services, LLC

  • Psychologist
  • New Albany, IN
  • NPI 1649787565
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1891274577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 E MAIN ST STE 201",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742287",
            "telephone_number": "630-377-6613",
            "fax_number": "630-377-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 E MAIN ST STE 201",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742287",
            "telephone_number": "630-377-6613",
            "fax_number": "630-377-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDRIDGE",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149020404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Korren Eiden, RDN, LDN
• Elizabeth Einstein, RD, LD
• Jenna Elyse Eisses, PA-C
• Kathryn Ann Ejnik, P.T.
• Helen Elayan
• Carol Elendt, LPC
• Erica L Elliott, ARNP
• Elmhurst Dental Group, LTD. Dba St. Charles Dental (St. Charles Dental)
• Embrace Counseling Center LLC
• Emerald Path Therapy LLC

• Clinical Social Worker in St Charles, IL
• Providers in St Charles, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2018; 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.

Verify at the official NPI Registry.