Healthcare Provider Details

I. General information

NPI: 1700385853
Provider Name (Legal Business Name): MS. RADESTA KEMPF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2018
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8416 CAREYS RUN POND CREEK RD LOT A
WEST PORTSMOUTH OH
45663-9045
US

IV. Provider business mailing address

8416 CAREYS RUN POND CREEK RD LOT A
WEST PORTSMOUTH OH
45663-9045
US

V. Phone/Fax

Practice location:
  • Phone: 740-529-8644
  • Fax:
Mailing address:
  • Phone: 740-529-8644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberCDCA.16210
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: