Individual provider Active NPI

Kimberly Dawn Choiniere, LCSW

  • Clinical Social Worker
  • Waxahachie, TX
National Provider Identifier
1104445261
Registry record updated Apr 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
31127 Issued in TX
Practice address
530 Hight Rd
Waxahachie, TX 75167-8945
Phone
(214) 463-3504
NPI assigned
Apr 9, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2020

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 31127 TX Primary

Addresses

Primary practice location

530 Hight Rd
Waxahachie, TX 75167-8945

Mailing address

809 Redbud Rd
Burleson, TX 76028-7047
Phone (817) 734-1755

Other identifiers 1

IdentifierTypeStateIssuer
31127OtherTXDEPARTMENT OF HEALTH AND HUMAN SERVICES

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
31127TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Discovery Point Retreat Past Accepting new patients
Discovery Point Retreat, Inc Past Accepting new patients

Organizations & group practices 2

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": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1104445261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 REDBUD RD",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760287047",
            "telephone_number": "817-734-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 HIGHT RD",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751678945",
            "telephone_number": "214-463-3504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOINIERE",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-09",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "31127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTH AND HUMAN SERVICES",
            "identifier": "31127",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waxahachie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; 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.