Active NPI
Kimberley D Thompson, LCSW
- Clinical Social Worker
- Amery, WI
National Provider Identifier
1124190046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6956-123
- Practice address
- 230 Deronda St
Amery, WI 54001-1412 - Phone
- (715) 268-8000
- NPI assigned
- Nov 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6956-123 | WI | Primary |
Addresses
Primary practice location
230 Deronda St
Amery, WI 54001-1412
Mailing address
PO Box 670
Ellsworth, WI 54011-0670
Phone (715) 273-6770
Other practice location 1
265 Griffin St E
Amery, WI 54001-1439
Phone (715) 268-8000
Other practice location 2
535 Hospital Rd
New Richmond, WI 54017-1449
Phone (715) 243-2600
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HP69910 | Other | MN | HEALTHPARTNERS |
| 920461025361 | Other | MN | PREFERRED ONE |
| 99F89TH | Other | MN | BLUECROSS BLUESHIELD |
| 43585400 | Medicaid | WI |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1124190046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 670",
"city": "ELLSWORTH",
"state": "WI",
"postal_code": "540110670",
"telephone_number": "715-273-6770",
"fax_number": "715-273-6862"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 DERONDA ST",
"city": "AMERY",
"state": "WI",
"postal_code": "540011412",
"telephone_number": "715-268-8000"
}
],
"practiceLocations": [
{
"address_1": "265 Griffin St E",
"address_purpose": "LOCATION",
"city": "Amery",
"state": "WI",
"postal_code": "540011439",
"country_code": "US",
"telephone_number": "715-268-8000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "535 Hospital Rd",
"address_purpose": "LOCATION",
"city": "New Richmond",
"state": "WI",
"postal_code": "540171449",
"country_code": "US",
"telephone_number": "715-243-2600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THOMPSON",
"first_name": "KIMBERLEY",
"middle_name": "D",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-15",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "6956-123",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP69910",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "920461025361",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "99F89TH",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43585400",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Amery, WI
Sources for this page
- 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.