Individual provider Active NPI

Kimberly Cooksey, LISW-S

  • Clinical Social Worker
  • Columbus, OH
National Provider Identifier
1275993008
Registry record updated Mar 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1000157.SUPV Issued in OH
Practice address
16 W Long St
Columbus, OH 43215-2815
Phone
(614) 225-0990
Fax
(614) 225-0988
NPI assigned
Mar 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2016

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 I.1000157.SUPV OH Primary

Addresses

Primary practice location

16 W Long St
Columbus, OH 43215-2815

Mailing address

16 W Long St
Columbus, OH 43215-2815
Phone (614) 225-0990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20160328002429 OH Practitioner - Clinical Social Worker 2668779133 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1000157.SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast, Inc CurrentSince Apr 1, 2016 Accepting new patients
Southeast, Inc CurrentSince Apr 1, 2016 Accepting new patients

Locations

16 W Long St
Columbus, OH 43215

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457308800000",
    "number": "1275993008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 W LONG ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432152815",
            "telephone_number": "614-225-0990",
            "fax_number": "614-225-0988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 W LONG ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432152815",
            "telephone_number": "614-225-0990",
            "fax_number": "614-225-0988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKSEY",
        "first_name": "KIMBERLY",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-07",
        "last_updated": "2016-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1000157.SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.