Kimberly Patrice Spivey, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.013263 Issued in IL

Practice address

5113 Monroe St
Matteson, IL 60443-3072

Phone

(708) 747-1292

Fax

(708) 747-1292

NPI assigned

Jan 22, 2011

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 IL

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

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Family and Community Resources PCGroup PAC ID 0345381018, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Midwest Family and Community Resources PC

  dba MFCR

  • Community/Behavioral Health Agency
  • Hazel Crest, IL
  • NPI 1770818064
  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, IL

  Medicare reassignment NPD
• Earnest Webb, PC

  • Community/Behavioral Health Agency
  • Homewood, IL
  • NPI 1669602744
  NPD (past)
• Intertwined

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1205168424
  NPD (past)

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

{
    "created_epoch": "1295654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295654400000",
    "number": "1245535269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5113 MONROE ST",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604433072",
            "telephone_number": "708-747-1292",
            "fax_number": "708-747-1292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5113 MONROE ST",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604433072",
            "telephone_number": "708-747-1292",
            "fax_number": "708-747-1292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIVEY",
        "first_name": "KIMBERLY",
        "middle_name": "PATRICE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-22",
        "last_updated": "2011-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.013263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Augustine Sohn, LCSW
• Southland Care Coordination Partners, Inc.
• Southland Care Coordination Partners, Inc.
• Zoe R Spada, DPT
• Special Care Transportaion
• Toni L Spraggins, CMT
• Cylia Rose Srmek
• St Nicholas Cila Homes Corporation
• Shakisha Starks, LPN
• Raven Stepter

• Clinical Social Worker in Matteson, IL
• Providers in Matteson, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2011; 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.