Individual provider Active NPI

Kimberly L. Griffin, LCSW

  • Clinical Social Worker
  • Greensboro, NC
National Provider Identifier
1043497449
Registry record updated Apr 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C005892 Issued in NC
Practice address
1400 Battleground Ave
134A
Greensboro, NC 27408-8042
Phone
(336) 272-3095
Fax
(336) 272-3088
NPI assigned
Jan 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2011

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 C005892 NC Primary

Addresses

Primary practice location

1400 Battleground Ave
134A
Greensboro, NC 27408-8042

Mailing address

1400 Battleground Ave
134A
Greensboro, NC 27408-8042
Phone (336) 272-3095

Other identifiers 1

IdentifierTypeStateIssuer
6106881MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C005892NCMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303344000000",
    "number": "1043497449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 BATTLEGROUND AVE",
            "address_2": "134A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274088042",
            "telephone_number": "336-272-3095",
            "fax_number": "336-272-3088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BATTLEGROUND AVE",
            "address_2": "134A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274088042",
            "telephone_number": "336-272-3095",
            "fax_number": "336-272-3088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "KIMBERLY",
        "middle_name": "L.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-28",
        "last_updated": "2011-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6106881",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.