Kimberly Peery

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW007307 Issued in GA

Practice address

4268 Canton Rd
Marietta, GA 30066-8301

Phone

(678) 821-9363

NPI assigned

May 27, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1790308591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4275 ARBOR CLUB DR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300662247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4268 CANTON RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300668301",
            "telephone_number": "678-821-9363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEERY",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-27",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "MSW007845",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatrics and Adolescent Medicine, PA
• Pediatrics at Whitlock P.C.
• Pediatrix Medical Group of Georgia, P.C.
• Tatiana Peduri
• Daniel Peeks, LAPC
• Kishwar Peiris, LPC
• Jenna Lee Peixoto, PT, DPT
• Soni Pelino, DPT
• Taylor Smith Pell, PT, DPT
• Amanda Y Pellerito, PA

• Clinical Social Worker in Marietta, GA
• Providers in Marietta, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; 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.