Individual provider Active NPI

Kailey Jean Karder, MSW

  • Social Worker
  • Peoria, IL
National Provider Identifier
1952122202
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
5101 N Executive Dr
Peoria, IL 61614-4868
Phone
(309) 408-1493
NPI assigned
Oct 21, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

5101 N Executive Dr
Peoria, IL 61614-4868

Mailing address

5101 N Executive Dr
Peoria, IL 61614-4868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20250317002158 IL Practitioner - Clinical Social Worker 4981126224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edge Counseling and Wellness LLCGroup PAC ID 1951659465, 8 clinicians

Practice addresses (Care Compare)

5101 N Executive Dr
Peoria, IL 61614-4868
Phone (309) 408-1493

719 W Lake Ave
Peoria, IL 61614-5941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Edge Counseling and Wellness LLC Clinical CurrentSince Jan 1, 2025 Accepting new patients

Locations

5101 N Executive Dr
Peoria, IL 61614
Phone (309) 408-1493

719 W Lake Ave
Peoria, IL 61614
Phone (309) 408-1493

Organizations & group practices 1

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": "1729468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1952122202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 N EXECUTIVE DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 N EXECUTIVE DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144868",
            "telephone_number": "309-408-1493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARDER",
        "first_name": "KAILEY JEAN",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-21",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.