Individual provider Active NPI

Kimbra Marie Buerschaper, LCSW

  • Clinical Social Worker
  • Kalispell, MT
National Provider Identifier
1851054209
Registry record updated Jan 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
54894 Issued in MT
Practice address
728 S Main St Ste 202
Kalispell, MT 59901-5342
Phone
(406) 356-6496
NPI assigned
Oct 21, 2021
Last updated
Jan 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2022

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 54894 MT Primary

Addresses

Primary practice location

728 S Main St Ste 202
Kalispell, MT 59901-5342

Mailing address

PO Box 10793
Kalispell, MT 59904-3793

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kimbra@kimbramarie.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20220315002353 MT Practitioner - Clinical Social Worker 5092100750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

728 S Main St
Suite 202
Kalispell, MT 59901-5342
Phone (406) 356-6496

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
54894MTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kimbra Marie PLLC CurrentSince Nov 4, 2021 Accepting new patients

Locations

728 S Main St
Ste 202
Kalispell, MT 59901
Phone (406) 356-6496

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641686400000",
    "number": "1851054209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10793",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599043793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 S MAIN ST STE 202",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599015342",
            "telephone_number": "406-356-6496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUERSCHAPER",
        "first_name": "KIMBRA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-21",
        "last_updated": "2022-01-09",
        "certification_date": "2022-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "54894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kimbra@kimbramarie.com",
            "affiliation": "N",
            "address_1": "728 S Main St Ste 202",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599015342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.