Ted M Kirk, SOCIAL WORKER

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LMSW004940 Issued in GA

Practice address

977A Taylor Street
Conyers, GA 30012

Phone

(770) 918-6677

Fax

(770) 918-6686

NPI assigned

Aug 8, 2011

Last updated

Aug 8, 2011By the provider in NPPES

Sex

Male

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

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.

• Grncsb

  • Point of Service
  • Conyers, GA
  • NPI 1952698227
  NPD (past) Authorized official
• GRN CSB

  • Case Manager/Care Coordinator
  • Conyers, GA
  • NPI 1891859377
  NPD (past)

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

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312761600000",
    "number": "1629357637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "977A TAYLOR STREET",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "30012",
            "telephone_number": "770-918-6677",
            "fax_number": "770-918-6686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "977A TAYLOR STREET",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "30012",
            "telephone_number": "770-918-6677",
            "fax_number": "770-918-6686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "TED",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "SOCIAL WORKER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-08",
        "last_updated": "2011-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "LMSW004940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marvin Brien King
• Steven P King, DDS
• Ganesh N Kini, MD
• Jason Kinkartz, MD
• Mary Diane Kinsella, M.D.
• Sarah Kirkpatrick, M. ED., CCC-SLP
• Annmarie Suzette Klein, RD
• Lindsey Klein, PTA
• Tania A. Klubenspies, D.C.
• Vanessa Knight

• Social Worker in Conyers, GA
• Providers in Conyers, GA by specialty
• Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2011; 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.