Individual provider Active NPI

Kimberly Elizabeth Holyst, MSW

  • Clinical Social Worker
  • Plainville, CT
National Provider Identifier
1255577672
Registry record updated Jan 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
74 East St
Plainville, CT 06062-2367
Phone
(860) 793-7280
NPI assigned
Jan 7, 2009
Last updated
Jan 7, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2009

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 Primary

Addresses

Primary practice location

74 East St
Plainville, CT 06062-2367

Mailing address

398 Steele Rd
New Hartford, CT 06057-2614
Phone (860) 738-0817

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20170104001378 CT Practitioner - Clinical Social Worker 0143501262 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8025CTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Johnson Memorial Hospital, Inc. CurrentSince Nov 5, 2016 Accepting new patients
Wheeler Clinic Inc CurrentSince Mar 20, 2019 Accepting new patients
Wheeler Clinic Inc CurrentSince Mar 20, 2019 Accepting new patients
Johnson Memorial Hospital, Inc. CurrentSince Nov 5, 2016 Accepting new patients

Locations

91 Northwest Dr
Plainville, CT 06062
Phone (860) 793-3871

201 Chestnut Hill Rd
Stafford Springs, CT 06076
Phone (860) 265-6521

Interoperability endpoints

  • Direct secure messaging: kimberly.holyst.p1@direct.wheelerclinic.nextgenshare.com

Organizations & group practices 4

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": "1231286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231286400000",
    "number": "1255577672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "398 STEELE RD",
            "city": "NEW HARTFORD",
            "state": "CT",
            "postal_code": "060572614",
            "telephone_number": "860-738-0817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 EAST ST",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060622367",
            "telephone_number": "860-793-7280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLYST",
        "first_name": "KIMBERLY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-07",
        "last_updated": "2009-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainville, CT

Sources for this page

Verify at the official NPI Registry.