Individual provider Active NPI

Kimberly Podmore, LMSW, CAADC

  • Clinical Social Worker
  • East Lansing, MI
National Provider Identifier
1245643899
Registry record updated Jun 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801092324 Issued in MI
Practice address
415 W Grand River Ave
East Lansing, MI 48823-4201
Phone
(517) 333-3741
NPI assigned
Jun 10, 2014
Last updated
Jun 10, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2014

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 6801092324 MI Primary

Addresses

Primary practice location

415 W Grand River Ave
East Lansing, MI 48823-4201

Mailing address

406 Hume Blvd
Lansing, MI 48917-4245
Phone (248) 939-2566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20140815000054 MI Practitioner - Clinical Social Worker 8022235019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Michigan State University College of Human Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Comprehensive Psychological Services PCGroup PAC ID 6800805060, 9 clinicians

Practice addresses (Care Compare)

2720 E Lansing Dr
East Lansing, MI 48823-7754
Phone (517) 337-2900

Merit-based Incentive Payment System (MIPS)

Final score
91.34 of 100Reported as group
Quality
78.33
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801092324MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Psychological Services PC CurrentSince Mar 1, 2015 Accepting new patients
Lion Heart Psychiatry, PLLC Past Accepting new patients
Comprehensive Psychological Service, PLLC PastSince Dec 9, 2019 Accepting new patients

Locations

2720 E Lansing Dr
East Lansing, MI 48823
Phone (517) 337-2900

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": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402358400000",
    "number": "1245643899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 HUME BLVD",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489174245",
            "telephone_number": "248-939-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W GRAND RIVER AVE",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488234201",
            "telephone_number": "517-333-3741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODMORE",
        "first_name": "KIMBERLY",
        "name_prefix": "Mrs.",
        "credential": "LMSW, CAADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-10",
        "last_updated": "2014-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801092324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.