Individual provider Active NPI

Kimberly Donat Ali, L.C.S.W.

  • Counselor
  • St Petersburg, FL
National Provider Identifier
1396807137
Registry record updated Sep 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
SW6302 Issued in FL
Practice address
6739 1St Ave S
St Petersburg, FL 33707-1307
Phone
(727) 341-1000
Fax
(727) 341-1000
NPI assigned
Dec 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X SW6302 FL Primary

Addresses

Primary practice location

6739 1St Ave S
St Petersburg, FL 33707-1307

Mailing address

6739 1St Avenue South
St Petersburg, FL 33707-1307
Phone (727) 341-1000

Other names 1

  • Kimberly Mary Donat Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20050607000592 FL Practitioner - Clinical Social Worker 6800839218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6739 1St Ave S
St Petersburg, FL 33707-1307

6739 1St S Ave
Saint Petersburg, FL 33707-1307
Phone (727) 341-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Solutions 4 Life Inc CurrentSince Apr 29, 2014 Accepting new patients
Joan S Mason LCSW Cap P a Past Accepting new patients

Locations

6739 1st Ave S
St Petersburg, FL 33707
Phone (727) 341-1000

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": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380067200000",
    "number": "1396807137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6739 1ST AVENUE SOUTH",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337071307",
            "telephone_number": "727-341-1000",
            "fax_number": "727-341-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6739 1ST AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337071307",
            "telephone_number": "727-341-1000",
            "fax_number": "727-341-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "KIMBERLY",
        "middle_name": "DONAT",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2013-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "SW6302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "DONAT",
            "middle_name": "MARY",
            "credential": "L.C.S.W.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.