Kimberly Maitland

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

0169542849 Issued in VA

Practice address

20920 Glenwood Ave
MC Kenney, VA 23872-2516

Phone

(804) 586-7113

Fax

(804) 375-1019

NPI assigned

Mar 27, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Maitland'S Care Services

  • Case Management Agency
  • McKenney, VA
  • NPI 1225556848

  Case Management

  NPD Authorized official

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490572800000",
    "number": "1871024232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20920 GLENWOOD AVE",
            "city": "MC KENNEY",
            "state": "VA",
            "postal_code": "238722516",
            "telephone_number": "804-586-7113",
            "fax_number": "804-375-1019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20920 GLENWOOD AVE",
            "city": "MC KENNEY",
            "state": "VA",
            "postal_code": "238722516",
            "telephone_number": "804-586-7113",
            "fax_number": "804-375-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAITLAND",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2017-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "VA",
            "license": "0169542849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0169542849",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in MC Kenney, VA
• Case Management Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2017; 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.