Individual provider Active NPI

Kristen Elaine Buchannan

  • Clinical Social Worker
  • Cleveland, OH
National Provider Identifier
1962740647
Registry record updated Jan 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0008245 Issued in OH
Practice address
2801 Martin Luther King Jr Dr
Cleveland, OH 44104-3815
Phone
(216) 448-6158
Fax
(216) 448-6342
NPI assigned
Jan 30, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2013

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 0008245 OH Primary

Addresses

Primary practice location

2801 Martin Luther King Jr Dr
Cleveland, OH 44104-3815

Mailing address

2801 Martin Luther King Jr Dr
Cleveland, OH 44104-3815
Phone (216) 448-6158

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
I20131008001094 OH Practitioner - Clinical Social Worker 5294969168 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0008245OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Sep 19, 2023 Accepting new patients

Locations

20 S 3rd St
Ste 210
Columbus, OH 43215
Phone (614) 208-4973

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": "1359504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359504000000",
    "number": "1962740647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 MARTIN LUTHER KING JR DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441043815",
            "telephone_number": "216-448-6158",
            "fax_number": "216-448-6342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 MARTIN LUTHER KING JR DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441043815",
            "telephone_number": "216-448-6158",
            "fax_number": "216-448-6342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCHANNAN",
        "first_name": "KRISTEN",
        "middle_name": "ELAINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-30",
        "last_updated": "2013-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "0008245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.