Individual provider Active NPI

Kimberley Carolyn Epperson, LCSW

  • Clinical Social Worker
  • Metairie, LA
National Provider Identifier
1750685756
Registry record updated May 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4407 Issued in LA
Practice address
3340 Severn Ave
Suite 206
Metairie, LA 70002-7407
Phone
(504) 889-1448
Fax
(504) 889-1452
NPI assigned
Jan 5, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2011

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 4407 LA Primary

Addresses

Primary practice location

3340 Severn Ave
Suite 206
Metairie, LA 70002-7407

Mailing address

3340 Severn Ave
Suite 206
Metairie, LA 70002-7407
Phone (504) 889-1448

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20110328000353 LA Practitioner - Clinical Social Worker 6507049681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson Psychiatric Associates LLCGroup PAC ID 9234361213, 7 clinicians

Practice addresses (Care Compare)

3901 Houma Blvd
Suite 401
Metairie, LA 70006-2930
Phone (504) 889-1448

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Psychiatric Associates LLC Clinical CurrentSince Dec 1, 2013 Accepting new patients

Locations

3340 Severn Ave
Ste 206
Metairie, LA 70002
Phone (504) 889-1448

3901 Houma Blvd
Ste 401
Metairie, LA 70006
Phone (504) 889-1448

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/05a97b88-f719-405f-abbb-125ac71b7cee/

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.

NPI Registry JSON

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

{
    "created_epoch": "1294185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305504000000",
    "number": "1750685756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 SEVERN AVE",
            "address_2": "SUITE 206",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700027407",
            "telephone_number": "504-889-1448",
            "fax_number": "504-889-1452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 SEVERN AVE",
            "address_2": "SUITE 206",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700027407",
            "telephone_number": "504-889-1448",
            "fax_number": "504-889-1452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPPERSON",
        "first_name": "KIMBERLEY",
        "middle_name": "CAROLYN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-05",
        "last_updated": "2011-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "4407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.