Shari K Kimball, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

111915-C Issued in AR

Practice address

1185 Highway 412 W
Siloam Springs, AR 72761-4551

Phone

(479) 373-1113

NPI assigned

Jul 10, 2015

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 names 1

• Sharon Kimball Amigo Former name

Medicare fee-for-service enrollment

Enrolled in AR

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, 2008

Medicare assignment

May accept Medicare assignment

Group practices

PT Concepts PLLCGroup PAC ID 1951669852, 25 clinicians

Practice addresses (Care Compare)

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.

• PT Concepts, PLLC

  • Mental Health Counselor
  • Rogers, AR
  • NPI 1164931291
  Medicare reassignment Care Compare group NPD
• My Therapy LLC

  • Mental Health Counselor
  • Rogers, AR
  • NPI 1598633091
  NPD (past)

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665187200000",
    "number": "1821472655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1185 HIGHWAY 412 W",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727614551",
            "telephone_number": "479-599-9603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 HIGHWAY 412 W",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727614551",
            "telephone_number": "479-373-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "SHARI",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-10",
        "last_updated": "2022-10-08",
        "certification_date": "2022-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "111915-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHARON",
            "last_name": "AMIGO",
            "middle_name": "KIMBALL",
            "credential": "LISW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kaitlyn Kear
• Kenneth Childers P a
• Kids Unlimited Learning Academy of Siloam Springs
• Kids Unlimited Learning Academy of Siloam Springs
• Matthew Scott Killingsworth, D.M.D.
• Jimmy Kue
• Sarah Gabrielle La Fleur
• Rachael Labitad
• Charles C Lampton, PH.D.
• Janan R. Lane, D.O.

• Clinical Social Worker in Siloam Springs, AR
• Providers in Siloam Springs, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2022; 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.