Individual provider Active NPI

Kimberly M Yarbro, LMSW

  • Social Worker
  • Atoka, TN
National Provider Identifier
1700513678
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
105240 Issued in TN
Practice address
76 Capital Way Ste C
Atoka, TN 38004-6866
Phone
(901) 840-1202
Fax
(901) 840-1204
NPI assigned
Aug 2, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 105240 TN Primary

Addresses

Primary practice location

76 Capital Way Ste C
Atoka, TN 38004-6866

Mailing address

1211 Union Ave Ste 330
Memphis, TN 38104-6655
Phone (901) 478-0966

Other practice location 1

6551 Stage Oaks Dr Ste 4
Bartlett, TN 38134-3895
Phone (901) 387-0026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20231208001791 TN Practitioner - Clinical Social Worker 1759730229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Primary Care Group, LLCGroup PAC ID 0941480131, 108 clinicians

Practice addresses (Care Compare)

76 Capital Way
Suite C
Atoka, TN 38004-6832
Phone (901) 840-1202

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8143TNMDMental Health Counselor
105240TNMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Group LLC CurrentSince Jan 29, 2024 Accepting new patients

Locations

76 Capital Way
Ste C
Atoka, TN 38004
Phone (901) 837-6674

2961 Canada Rd
Ste 105
Lakeland, TN 38002
Phone (901) 388-0115

1211 Union Ave
Ste 330
Memphis, TN 38104
Phone (901) 478-0954

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1659398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1700513678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 330",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046655",
            "telephone_number": "901-478-0966",
            "fax_number": "901-478-0951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 CAPITAL WAY STE C",
            "city": "ATOKA",
            "state": "TN",
            "postal_code": "380046866",
            "telephone_number": "901-840-1202",
            "fax_number": "901-840-1204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6551 Stage Oaks Dr Ste 4",
            "address_purpose": "LOCATION",
            "city": "Bartlett",
            "state": "TN",
            "postal_code": "381343895",
            "country_code": "US",
            "telephone_number": "901-387-0026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YARBRO",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-02",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TN",
            "license": "105240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atoka, TN

Sources for this page

Verify at the official NPI Registry.