Active NPI
Kimberly E Browder
- Mental Health Counselor
- Wasilla, AK
National Provider Identifier
1225535800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 7010 E Bogard Rd
Wasilla, AK 99654-4711 - Phone
- (907) 206-4301
- NPI assigned
- Apr 10, 2018
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
7010 E Bogard Rd
Wasilla, AK 99654-4711
Mailing address
PO Box 876741
Wasilla, AK 99687-6741
Phone (907) 206-4301
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1020986 | Medicaid | AK |
Other names 1
- Kimberly E Bass Gordon
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692662400000",
"number": "1225535800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 876741",
"city": "WASILLA",
"state": "AK",
"postal_code": "996876741",
"telephone_number": "907-206-4301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7010 E BOGARD RD",
"city": "WASILLA",
"state": "AK",
"postal_code": "996544711",
"telephone_number": "907-206-4301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWDER",
"first_name": "KIMBERLY",
"middle_name": "E",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-10",
"last_updated": "2023-08-22",
"certification_date": "2023-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1020986",
"state": "AK"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KIMBERLY",
"last_name": "BASS GORDON",
"middle_name": "E",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Wasilla, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.