Individual provider Active NPI

Kimberly Hart

  • Marriage & Family Therapist
  • Valparaiso, IN
National Provider Identifier
1972197200
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
1551 Sturdy Rd Ste 3
Valparaiso, IN 46383-7829
Phone
(219) 531-0111
Fax
(219) 224-4133
NPI assigned
Feb 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

1551 Sturdy Rd Ste 3
Valparaiso, IN 46383-7829

Mailing address

1551 Sturdy Rd Ste 3
Valparaiso, IN 46383-7829
Phone (219) 531-0111

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240516001803 IN Practitioner - Marriage and Family Therapist 0941641344 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shannon Johnson LLCGroup PAC ID 5294173522, 3 clinicians

Practice addresses (Care Compare)

1551 Sturdy Rd
Suite 3
Valparaiso, IN 46383-7829
Phone (219) 531-0111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Porter-Starke Services Inc. CurrentSince Apr 10, 2024 Accepting new patients
Shannon Johnson LLC Marriage & Family Therapist CurrentSince Feb 24, 2025 Accepting new patients
Porter-Starke Services Inc. CurrentSince Apr 10, 2024 Accepting new patients

Locations

3229 Broadway
Ste 115
Gary, IN 46409
Phone (219) 806-3000

3229 Broadway
Ste 104
Gary, IN 46409
Phone (219) 487-5800

704 S State Road 2
Hebron, IN 46341
Phone (219) 806-3011

1001 S Edgewood Dr
Ste 1
Knox, IN 46534
Phone (574) 772-4040

3176 Lancer St
Ste B
Portage, IN 46368
Phone (219) 806-3000

601 Wall St
Valparaiso, IN 46383
Phone (219) 806-3011

701 Wall St
Valparaiso, IN 46383
Phone (219) 299-8419

1551 Sturdy Rd
Ste 3
Valparaiso, IN 46383
Phone (219) 531-0111

Organizations & group practices 3

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": "1614297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1972197200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 STURDY RD STE 3",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463837829",
            "telephone_number": "219-531-0111",
            "fax_number": "219-224-4133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 STURDY RD STE 3",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463837829",
            "telephone_number": "219-531-0111",
            "fax_number": "219-224-4133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-26",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

Verify at the official NPI Registry.