Active NPI
Kimberlie Marie Simms, LCSW
- Clinical Social Worker
- Salt Lake City, UT
National Provider Identifier
1821589789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 11152697
- Practice address
- 5284 S Commerce Dr Ste C134
Salt Lake City, UT 84107-5360 - Phone
- (801) 266-4643
- NPI assigned
- May 25, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S.1802359 | OH | |
| Clinical Social Worker | 1041C0700X | 11152697 | UT | Primary |
Addresses
Primary practice location
5284 S Commerce Dr Ste C134
Salt Lake City, UT 84107-5360
Mailing address
45 E Vine St
Murray, UT 84107-7904
Phone (801) 266-4643
Other practice location 1
700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-5793
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1473276 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.1802359 | OH | MD | Social Worker |
| 11152697 | UT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michelle Chaban, P.C. | Past | Accepting new patients |
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.
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- Deerfield, IL
- NPI 1437105061
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643673600000",
"number": "1821589789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 E VINE ST",
"city": "MURRAY",
"state": "UT",
"postal_code": "841077904",
"telephone_number": "801-266-4643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5284 S COMMERCE DR STE C134",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841075360",
"telephone_number": "801-266-4643"
}
],
"practiceLocations": [
{
"address_1": "700 Childrens Dr",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "OH",
"postal_code": "43205",
"country_code": "US",
"telephone_number": "614-722-5793",
"fax_number": "614-722-9069",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SIMMS",
"first_name": "KIMBERLIE",
"middle_name": "MARIE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-25",
"last_updated": "2022-02-01",
"certification_date": "2022-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.1802359",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "11152697",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1473276",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.