MEDICARE: MS. RADESTA KEMPF

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator	CDCA.16210	OH
2	3747P1801X	Personal Care Attendant		OH

General Provider Information

NPI Number	:	1700385853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RADESTA KEMPF

Provider Business Mailing Address
First Line	:	8416 CAREYS RUN POND CREEK RD LOT A
Second Line	:
City	:	WEST PORTSMOUTH
State	:	OH
Zip	:	45663-9045
Country	:	US
Telephone Number	:	740-529-8644
Fax Number	:

Provider Business Practice Location Address
First Line	:	8416 CAREYS RUN POND CREEK RD
Second Line	:	LOT A
City	:	WEST PORTSMOUTH
State	:	OH
Zip	:	45663-9045
Country	:	US
Telephone Number	:	740-529-8644
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2018
Last Update Date	:	09/10/2025

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