Kimberly M Meek

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

23440 Issued in FL

Practice address

1067 E Brandon Blvd
Brandon, FL 33511-5515

Phone

(813) 548-1166

NPI assigned

Feb 10, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 7

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Selah - a Space Between, LLCGroup PAC ID 5496243040, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Selah - a Space Between, LLC

  • Clinical Social Worker
  • Temple Terrace, FL
  • NPI 1710860374
  Medicare reassignment Care Compare group NPD Authorized official
• New Life 360 Temple Terrace Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brandon, FL
  • NPI 1689496911

  Adult Mental Health

  NPD Authorized official
• New Life 360 Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Brandon, FL
  • NPI 1417439282
  NPD (past)

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1114671807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 VANDERBAKER RD",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336177867",
            "telephone_number": "813-418-1966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1067 E BRANDON BLVD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115515",
            "telephone_number": "813-548-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEEK",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-10",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "23440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE INSURANCE",
            "identifier": "88-0610335",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "doxy.me",
            "affiliation": "N",
            "endpointDescription": "telehealth",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "URL",
            "address_1": "1067 E Brandon Blvd",
            "city": "Brandon",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335115515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Priscila Andrea Medina, ATC
• Rosalinda Medina, AA
• Medisupport Services Express
• Meditech Medical Centers, LLC
• Dana Medlin
• Dhirendra Indulal Mehta, M.D.
• Magda Elkabani Melchert, MD
• Mary Elizabeth Melendez, D.C.
• Amber Melero, PA-C
• Mark David Mellman, DDS

• Clinical Social Worker in Brandon, FL
• Providers in Brandon, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.