Kristopher Lee Komarek, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6832-C Issued in NV

Practice address

783 Basque Way Ste 110
Carson City, NV 89706-7981

Phone

(775) 400-2996

Fax

(866) 244-3992

NPI assigned

Aug 21, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3193/brand/1/csg/1/fhir/r4

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.

• Litedpath, LLC

  • Community/Behavioral Health Agency
  • Carson City, NV
  • NPI 1295488799
  NPD Authorized official

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

{
    "created_epoch": "1345507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063760106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 GOLDEN PICK DR",
            "city": "DAYTON",
            "state": "NV",
            "postal_code": "894037412",
            "telephone_number": "775-246-0752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "783 BASQUE WAY STE 110",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897067981",
            "telephone_number": "775-400-2996",
            "fax_number": "866-244-3992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMAREK",
        "first_name": "KRISTOPHER",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "6832-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "6832-C",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Ann Knowles, AGACNP-C
• Sandra Koch, M.D.
• Michaela Koenig, M.S.W.
• Danielle Kohler
• Varun Kohli, MD
• Kona Chiropractic LLC
• Sheldon M Kop, MD
• Kristin Nicole Koskela, M.D.
• Shannon Lee Kossick, LCSW, LCADC
• Susan Jacqueline Kotler, PH.D, ABPP/ABCN

• Clinical Social Worker in Carson City, NV
• Providers in Carson City, NV by specialty
• Clinical Social Worker in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.