Kimberly Kay Elliott

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

92580 Issued in CA

Practice address

1255 Liberty St
Redding, CA 96001-0814

Phone

(530) 246-2467

NPI assigned

Oct 21, 2019

Last updated

Oct 21, 2019By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Clinical Social Worker

Education

Other, 2000

Medicare assignment

May accept Medicare assignment

Group practices

Hill Country Community ClinicGroup PAC ID 1052442175, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kim.elliottmsaba.p1@direct.schc.nextgenshare.com

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.

• Hill Country Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Round Mountain, CA
  • NPI 1407914260
  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846
  Medicare reassignment
• Hill Country Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Redding, CA
  • NPI 1568338218
  NPD
• Hill Country Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Redding, CA
  • NPI 1689114043
  NPD

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1760025886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 FRESIA WAY",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960033041",
            "telephone_number": "530-356-8427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 LIBERTY ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010814",
            "telephone_number": "530-246-2467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "KIMBERLY",
        "middle_name": "KAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-21",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "92580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "92580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Norma Ellenwood
• Quyntz Ellenwood, OTRL
• Elliott Acupuncture Clinic
• Cameryn T Elliott, L.AC.
• John Granville Elliott, L.AC.
• Timothy A Elliott, CO
• Ashley Elaine Ellis, MA, LMFT
• John Phillip Elmore, MFT
• Kevin S Elo, PT
• Emergent Neurology & Telemedicine Inc

• Clinical Social Worker in Redding, CA
• Providers in Redding, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.