Individual provider Active NPI

Krista Lynn Bednarski-Gibbs, LCSW PLC

  • Clinical Social Worker
  • Winchester, VA
National Provider Identifier
1437266764
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
110 Lauck Drive
Winchester, VA 22603
Phone
(540) 667-7830
Fax
(540) 667-2941
NPI assigned
Aug 24, 2006
Last updated
Nov 27, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

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 VA Primary

Addresses

Primary practice location

110 Lauck Drive
Winchester, VA 22603

Mailing address

507 Brookneil Drive
Winchester, VA 22602
Phone (540) 550-5044

Other identifiers 1

IdentifierTypeStateIssuer
182020OtherVABCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20051219000605 VA Practitioner - Clinical Social Worker 1456373455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

104 Selma Dr
Winchester, VA 22601-3834
Phone (540) 550-5044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
090400447VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kristal Bednarski-Gibbs, LCSW, PLC Clinical CurrentSince Jul 20, 2005 Accepting new patients
T Med Behavioral Inc Clinical Past Accepting new patients

Locations

104 Selma Dr
Winchester, VA 22601
Phone (540) 542-6106

110 Lauck Dr
Winchester, VA 22603
Phone (540) 667-7830

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, 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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196121600000",
    "number": "1437266764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 BROOKNEIL DRIVE",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "22602",
            "telephone_number": "540-550-5044",
            "fax_number": "540-667-2941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LAUCK DRIVE",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "22603",
            "telephone_number": "540-667-7830",
            "fax_number": "540-667-2941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDNARSKI-GIBBS",
        "first_name": "KRISTA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LCSW  PLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "182020",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.