Kimberly Kay Pore, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

39509 Issued in TX

Practice address

1460 Walnut St
Columbus, TX 78934-2131

Phone

(979) 732-6204

Fax

(979) 732-5289

NPI assigned

Mar 26, 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 TX

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

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.

• Texana Center

  • Multi-Specialty Clinic/Center
  • Rosenberg, TX
  • NPI 1912954058
  NPD

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

{
    "created_epoch": "1301097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354665600000",
    "number": "1366741522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 WALNUT ST",
            "city": "COLUMBUS",
            "state": "TX",
            "postal_code": "789342131",
            "telephone_number": "979-732-6204",
            "fax_number": "979-732-5289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 WALNUT ST",
            "city": "COLUMBUS",
            "state": "TX",
            "postal_code": "789342131",
            "telephone_number": "979-732-6204",
            "fax_number": "979-732-5289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORE",
        "first_name": "KIMBERLY",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-26",
        "last_updated": "2012-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "39509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• One0Eight Services & Holdings, LLC
• Marcus Karlan Parker, M.D.
• Kajalben M Patel
• PBD Services 2, LLC
• Gregory William Petrosky
• Rachal Post, PT
• Powell Professional Services, LLC
• Russell Wayne Prause, D.C.
• Jessica A Radley, FNP-BC
• Kelly Randermann, APRN, FNP-C

• Clinical Social Worker in Columbus, TX
• Providers in Columbus, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.