Active NPI
Kimberly Chinn
- Social Worker
- Powder Springs, GA
National Provider Identifier
1154825701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- MSW005217
- Practice address
- 4171 Marietta St Ste 100B
Powder Springs, GA 30127-4800 - Phone
- (678) 310-3012
- NPI assigned
- Mar 20, 2018
- Last updated
- Mar 20, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | MSW005217 | GA | Primary |
Addresses
Primary practice location
4171 Marietta St Ste 100B
Powder Springs, GA 30127-4800
Mailing address
4695 N Church LN SE Apt 9203
Atlanta, GA 30339-1585
Phone (404) 840-1382
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
| License | State | Type | Specialty |
|---|---|---|---|
| MSW005217 | GA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521504000000",
"number": "1154825701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4695 N CHURCH LN SE APT 9203",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303391585",
"telephone_number": "404-840-1382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4171 MARIETTA ST STE 100B",
"city": "POWDER SPRINGS",
"state": "GA",
"postal_code": "301274800",
"telephone_number": "678-310-3012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHINN",
"first_name": "KIMBERLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-20",
"last_updated": "2018-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "GA",
"license": "MSW005217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Powder Springs, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.