Individual provider Active NPI

Kimberly Ann Brothers-Sharp

  • Clinical Social Worker
  • Shepherdsville, KY
National Provider Identifier
1861414112
Registry record updated Mar 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1725 Issued in KY
Practice address
130 S Joe B Hall Ave
Shepherdsville, KY 40165
Phone
(502) 589-8600
Fax
(502) 589-8771
NPI assigned
Jul 24, 2006
Last updated
Mar 6, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2015

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 1725 KY Primary

Addresses

Primary practice location

130 S Joe B Hall Ave
Shepherdsville, KY 40165

Mailing address

101 W Muhammad Ali Blvd
Louisville, KY 40202-1423
Phone (502) 589-8600

Other identifiers 1

IdentifierTypeStateIssuer
7100283610MedicaidKY

Other names 1

  • Kimberly Brothers Former name

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

LicenseStateTypeSpecialty
1725KYMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425600000000",
    "number": "1861414112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W MUHAMMAD ALI BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021423",
            "telephone_number": "502-589-8600",
            "fax_number": "502-589-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S JOE B HALL AVE",
            "city": "SHEPHERDSVILLE",
            "state": "KY",
            "postal_code": "40165",
            "telephone_number": "502-589-8600",
            "fax_number": "502-589-8771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROTHERS-SHARP",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2015-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "1725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100283610",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "BROTHERS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Shepherdsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2015; 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.