Active NPI
Kimberly Haywood
- Clinical Social Worker
- Falls Church, VA
National Provider Identifier
1396974879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904004333
- Practice address
- 207 Park Ave
Suite 3B
Falls Church, VA 22046-4312 - Phone
- (703) 966-1060
- NPI assigned
- Jul 6, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904004333 | VA | Primary |
Addresses
Primary practice location
207 Park Ave
Suite 3B
Falls Church, VA 22046-4312
Mailing address
207 Park Ave
Suite 3B
Falls Church, VA 22046-4312
Phone (703) 966-1060
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150731014969 | DC | Practitioner - Clinical Social Worker | 8123332376 | Practice locations: Falls Church, VA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
207 Park Ave
B3
Falls Church, VA 22046-4312
Phone (703) 966-1060
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0904004333 | VA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425600000000",
"number": "1396974879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 PARK AVE",
"address_2": "SUITE 3B",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "220464312",
"telephone_number": "703-966-1060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 PARK AVE",
"address_2": "SUITE 3B",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "220464312",
"telephone_number": "703-966-1060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYWOOD",
"first_name": "KIMBERLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-06",
"last_updated": "2015-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904004333",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Falls Church, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2015; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.