NPIMap

Individual provider Active NPI

Linda A Kimball, LMSW

  • Social Worker
  • Okemos, MI
National Provider Identifier
1114254661
Registry record updated Mar 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801070099 Issued in MI
Practice address
3493 Woods Edge Dr
Suite 103
Okemos, MI 48864
Phone
(517) 886-3707
Fax
(517) 349-1973
NPI assigned
Nov 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801070099 MI
Social Worker 104100000X 6801070099 MI Primary

Addresses

Primary practice location

3493 Woods Edge Dr
Suite 103
Okemos, MI 48864

Mailing address

3493 Woods Edge Dr
Suite 103
Okemos, MI 48864
Phone (517) 886-3707

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mareck Family and Geriatric Services, P.C. Clinical PastSince Sep 15, 2013 Accepting new patients

Organizations & group practices 1

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": "1257292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299110400000",
    "number": "1114254661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3493 WOODS EDGE DR",
            "address_2": "SUITE 103",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "48864",
            "telephone_number": "517-886-3707",
            "fax_number": "517-349-1973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3493 WOODS EDGE DR",
            "address_2": "SUITE 103",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "48864",
            "telephone_number": "517-886-3707",
            "fax_number": "517-349-1973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "LINDA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-04",
        "last_updated": "2011-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801070099",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801070099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.