Kimberly Waine Gore, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904012385 Issued in VA

Practice address

1651 Merrimac TRL BLDG 1
Williamsburg, VA 23185-5624

Phone

(757) 220-3200

Fax

(757) 253-4118

NPI assigned

Oct 19, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Middle Peninsula Northern Neck Mental Health & Retardation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gloucester, VA
  • NPI 1497717615
  Medicare reassignment NPD
• Middle Peninsula-Northern Neck Mental Health and Mental Retardation

  • Speech-Language Pathologist
  • Urbanna, VA
  • NPI 1992879282
  NPD
• Colonial Behavioral Health

  • Health Maintenance Organization
  • Williamsburg, VA
  • NPI 1841556776
  NPD (past)

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1700485927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8435 TAVERNS LN",
            "city": "TOANO",
            "state": "VA",
            "postal_code": "231688000",
            "telephone_number": "757-218-5133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 MERRIMAC TRL BLDG 1",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855624",
            "telephone_number": "757-220-3200",
            "fax_number": "757-253-4118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORE",
        "first_name": "KIMBERLY",
        "middle_name": "WAINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-19",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904012385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgore@colonialbh.org",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email address",
            "address_1": "1651 Merrimac Trl Bldg 1",
            "city": "Williamsburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "231855624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Heidi Goo, MD
• Lauren Goodman
• Goodwin & Snyder Anesthesia Associates, PLLC
• Cameron Michelle Gordon, DPT
• Maegan Gordon
• John Howell Gorman, RPH
• Devon Marie Gosnell, CSFA
• Rustico Tolentino Gotico, M.D.
• Linda P Gottfried, M.D.
• Daniel William Gotthardt, ATC, EMT-B, CSCS

• Clinical Social Worker in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.