Individual provider Active NPI

Kimberly D. Goeger, LCSW

  • Clinical Social Worker
  • Wylie, TX
National Provider Identifier
1578677027
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
37260 Issued in TX
Practice address
1730 Wildflower LN
Wylie, TX 75098-6689
Phone
(214) 236-2491
NPI assigned
Aug 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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 37260 TX Primary

Addresses

Primary practice location

1730 Wildflower LN
Wylie, TX 75098-6689

Mailing address

1730 Wildflower LN
Wylie, TX 75098-6689
Phone (214) 236-2491

Other practice location 1

2501 W William Cannon Dr Ste A
Austin, TX 78745-5281
Phone (512) 344-9181

Other identifiers 1

IdentifierTypeStateIssuer
170169002MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050122000063 TX Practitioner - Clinical Social Worker 8527018019 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1730 Wildflower LN
Wylie, TX 75098-6689
Phone (469) 209-0242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vonzee Interests LLC CurrentSince Sep 1, 2022 Accepting new patients
Michelle Zee Enterprises LLC Clinical PastSince Sep 1, 2022 Accepting new patients
Planned Living Assistance Network of North Texas Inc Clinical Past Accepting new patients

Locations

2501 W William Cannon Dr
Ste 6A
Austin, TX 78745
Phone (512) 344-9181

Organizations & group practices 4

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1578677027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 WILDFLOWER LN",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750986689",
            "telephone_number": "214-236-2491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 WILDFLOWER LN",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750986689",
            "telephone_number": "214-236-2491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 W William Cannon Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787455281",
            "country_code": "US",
            "telephone_number": "512-344-9181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOEGER",
        "first_name": "KIMBERLY",
        "middle_name": "D.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "37260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170169002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wylie, TX

Sources for this page

Verify at the official NPI Registry.