Individual provider Active NPI

Jerry David Kivett-Kimbro

  • Clinical Social Worker
  • Asheville, NC
National Provider Identifier
1689310153
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C013801 Issued in NC
Practice address
1100 Tunnel Rd
Asheville, NC 28805-2576
Phone
(904) 534-2359
NPI assigned
May 9, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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 C013801 NC Primary

Addresses

Primary practice location

1100 Tunnel Rd
Asheville, NC 28805-2576

Mailing address

21 Crayton Park Dr
Asheville, NC 28803-0395
Phone (904) 534-2359

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
C013801NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1652054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1689310153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 CRAYTON PARK DR",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288030395",
            "telephone_number": "904-534-2359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 TUNNEL RD",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288052576",
            "telephone_number": "904-534-2359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIVETT-KIMBRO",
        "first_name": "JERRY",
        "middle_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-09",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C013801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; 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.