Individual provider Active NPI

Amber Key

  • Clinical Social Worker
  • Tipp City, OH
National Provider Identifier
1952752917
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1901542-SUPV Issued in OH
Practice address
1483 W Main St
Tipp City, OH 45371-2803
Phone
(937) 937-3350
NPI assigned
Jun 30, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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 I.1901542-SUPV OH Primary

Addresses

Primary practice location

1483 W Main St
Tipp City, OH 45371-2803

Mailing address

485 Brookwood Dr
Troy, OH 45373-4511
Phone (937) 272-2263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20211014000709 OH Practitioner - Clinical Social Worker 3678971173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Wright State University Boonshoft School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Darke County Recovery ServicesGroup PAC ID 7315176005, 18 clinicians

Practice addresses (Care Compare)

1483 W Main St
Tipp City, OH 45371-2803
Phone (937) 335-0361

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1901542-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Darke County Recovery Services CurrentSince Jul 21, 2022 Accepting new patients

Locations

600 Walnut St
Greenville, OH 45331
Phone (937) 335-0361

212 E Main St
Greenville, OH 45331
Phone (937) 423-6344

1483 W Main St
Tipp City, OH 45371
Phone (937) 335-0361

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/recoveryandwellnessohio/r4/

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": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1952752917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "485 BROOKWOOD DR",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453734511",
            "telephone_number": "937-272-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1483 W MAIN ST",
            "city": "TIPP CITY",
            "state": "OH",
            "postal_code": "453712803",
            "telephone_number": "937-937-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEY",
        "first_name": "AMBER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1901542-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tipp City, OH

Sources for this page

Verify at the official NPI Registry.