Kimberly Ann Locke, L.I.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

16497 Issued in MN

Practice address

5320 Hyland Greens Dr
Bloomington, MN 55437

Phone

(952) 993-2400

Fax

(952) 993-2522

NPI assigned

Apr 1, 2012

Last updated

Aug 14, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1780621904
  Medicare reassignment Care Compare group NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1063897593
  NPD
• Park Nicollet Methodist Hospital

  dba Park Nicollet Methodist Hospital Outpatient Surgery Center

  • General Acute Care Hospital
  • St Louis Park, MN
  • NPI 1194113217
  NPD

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

{
    "created_epoch": "1333238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1225304405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5320 HYLAND GREENS DR",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554373934",
            "telephone_number": "952-993-2400",
            "fax_number": "952-993-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 HYLAND GREENS DR",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "55437",
            "telephone_number": "952-993-2400",
            "fax_number": "952-993-2522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2450 Riverside Ave",
            "address_2": "Adult Day Treatment-West #F29C",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554541450",
            "country_code": "US",
            "telephone_number": "612-273-9107",
            "fax_number": "612-273-9110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOCKE",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-01",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Living Promise, LLC (Promise Care)
• Miah Faye Livingston
• Pablo Luis Lizardi, MD
• Kimberly Lloyd, EDS
• Hunter Toukeng Lo
• Jennifer Elise Lodahl, PHARMD
• Jessica Loehr, OPTOMETRIST
• Michelle Lofquist
• Maryann Ruth Loftus, CDE
• Jasemine Lafaye Logan

• Clinical Social Worker in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; 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.