Individual provider Active NPI

Anna Rachel Kim, LGSW

  • Social Worker
  • Morgantown, WV
National Provider Identifier
1487109682
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
BP00944721 Issued in WV
Practice address
165 Scott Ave Ste 208
Morgantown, WV 26508-8847
Phone
(304) 292-1716
NPI assigned
Aug 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X BP00944721 WV Primary

Addresses

Primary practice location

165 Scott Ave Ste 208
Morgantown, WV 26508-8847

Mailing address

165 Scott Ave Ste 208
Morgantown, WV 26508-8847
Phone (304) 292-1716

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
BP00944721WVMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471478400000",
    "number": "1487109682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 SCOTT AVE STE 208",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265088847",
            "telephone_number": "304-292-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 SCOTT AVE STE 208",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265088847",
            "telephone_number": "304-292-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ANNA",
        "middle_name": "RACHEL",
        "credential": "LGSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-18",
        "last_updated": "2016-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WV",
            "license": "BP00944721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.