Individual provider Active NPI

Kim Jones, PHD

  • Clinical Social Worker
  • Little Rock, AR
National Provider Identifier
1245318781
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1316-C Issued in AR
Practice address
7509 Cantrell Rd Ste 217
Little Rock, AR 72207-2500
Phone
(501) 420-2185
NPI assigned
Nov 1, 2006
Last updated
Oct 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1316-C AR Primary

Addresses

Primary practice location

7509 Cantrell Rd Ste 217
Little Rock, AR 72207-2500

Mailing address

7509 Cantrell Rd Ste 217
Little Rock, AR 72207-2500
Phone (501) 420-2185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20040923000314 AR Practitioner - Clinical Social Worker 8628046026 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1316-CARMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 2004 Accepting new patients
The Center for Mindful Healing CurrentSince Nov 28, 2021 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 2004 Accepting new patients

Locations

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

4301 W Markham St
#825
Little Rock, AR 72205
Phone (501) 526-8200

7509 Cantrell Rd
Ste 217
Little Rock, AR 72207
Phone (501) 420-2185

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1245318781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7509 CANTRELL RD STE 217",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722072500",
            "telephone_number": "501-420-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7509 CANTRELL RD STE 217",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722072500",
            "telephone_number": "501-420-2185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "KIM",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "1316-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.