Mara Alexis Kirkpatrick

Primary specialty

Social WorkerTaxonomy code 104100000X

License

SW042015462 Issued in WV

Practice address

65 Professional PL Ste 102
Bridgeport, WV 26330-0259

Phone

(304) 848-5770

NPI assigned

May 18, 2020

Last updated

Dec 14, 2022By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Community Care of West Virginia, Inc.

  dba Community Care of Bridgeport

  • Federally Qualified Health Center (FQHC)
  • Bridgeport, WV
  • NPI 1619348844
  NPD
• Community Care of West Virginia Inc

  dba CareXpress of Slaty Fork

  • Federally Qualified Health Center (FQHC)
  • Slatyfork, WV
  • NPI 1215741665
  NPD (past)

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1598387110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 PROFESSIONAL PL STE 102",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263300259",
            "telephone_number": "304-848-5770",
            "fax_number": "304-848-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 PROFESSIONAL PL STE 102",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263300259",
            "telephone_number": "304-848-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKPATRICK",
        "first_name": "MARA",
        "middle_name": "ALEXIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-18",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WV",
            "license": "SW042015462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kidney Dialysis & Transplant Group Incorporated
• McKenna Killion
• Natalie R King-Selario, DO
• Richard Wade King, M.D.
• Susan Rennae Kirkendall, MS,AADC
• Padraig Kirkwood
• Courtney Danielle Kisamore, LGSW
• Christina Kitsos, M.D.
• Eleni Kitsos, M.D.
• Amber Nicole Klema, LCSW

• Social Worker in Bridgeport, WV
• Providers in Bridgeport, WV by specialty
• Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; 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.