Kimbra Leigh McKinley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3757 Issued in TN

Practice address

4038 Gap Road Suite 202
Knoxville, TN 37912-5940

Phone

(865) 525-0391

Fax

(865) 525-0393

NPI assigned

Apr 10, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kimbra Leigh Ippolito Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242950400000",
    "number": "1245453216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4038 GAP RD STE 202",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379125940",
            "telephone_number": "865-525-0391",
            "fax_number": "865-525-0393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4038 GAP ROAD SUITE 202",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379125940",
            "telephone_number": "865-525-0391",
            "fax_number": "865-525-0393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINLEY",
        "first_name": "KIMBRA",
        "middle_name": "LEIGH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2009-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "3757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBRA",
            "last_name": "IPPOLITO",
            "middle_name": "LEIGH",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Frank Robert McKeown III III, MD
• Edward Warren McKie
• Christopher Blake McKinless, D.O.
• Brian Wayne McKinley, ACNP-BC
• Cary June McKinley
• Sandra Lee McKinley, OTR
• W Michael McKinley, PTA
• Eric McKinney
• Glen Barden McKinney, MD
• James Cole McKinney, PHARMD

• Clinical Social Worker in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.