Kim M Spader, P-LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P005956 Issued in NC

Practice address

908 Walnut St
Wilmington, NC 28401-4232

Phone

(617) 314-5345

NPI assigned

Jul 21, 2010

Sex

Female

Sole proprietor

No

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 NC

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

Specialty

Clinical Social Worker

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Jenifer Phelps, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wilmington, NC
  • NPI 1174915185
  NPD (past)
• Kimberly M Spader PLLC

  • Early Intervention Provider Agency
  • Wilmington, NC
  • NPI 1144687260
  NPD (past)
• Sand Dollar Wellness Center, P.C.

  • Counselor
  • Wilmington, NC
  • NPI 1164872883
  NPD (past)

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

{
    "created_epoch": "1279670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279670400000",
    "number": "1477866259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 WALNUT ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284014232",
            "telephone_number": "617-314-5345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 WALNUT ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284014232",
            "telephone_number": "617-314-5345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPADER",
        "first_name": "KIM",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "P-LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-21",
        "last_updated": "2010-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P005956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southside Medical Center, PA
• Sovereign Solutions Logistics
• Max Gilbert Sox Jr.
• Kristina Spackman, M. S.
• Zoe Spadaro, OTR/L
• Jessica Spaeth, PSY.D.
• Leta Olivia Spain
• Jessica May Spanton, RBT ASSISTANT
• Bryan Thomas Sparks, PHARMD
• SPC Home Health LLC

• Clinical Social Worker in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; 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.

Verify at the official NPI Registry.