Individual provider Active NPI

Kimberly Anne McBryde, LLMSW

  • Social Worker
  • Mt Pleasant, MI
National Provider Identifier
1902476377
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801110496 Issued in MI
Practice address
2790 Health Pkwy
Mt Pleasant, MI 48858-6934
Phone
(989) 779-5642
NPI assigned
Jun 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801110496 MI Primary

Addresses

Primary practice location

2790 Health Pkwy
Mt Pleasant, MI 48858-6934

Mailing address

2790 Health Pkwy
Mt Pleasant, MI 48858-6934
Phone (989) 779-5642

Other names 1

  • Kimberly Anne Benoit Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20210701001643 MI Practitioner - Clinical Social Worker 4587065230 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Isabella Citizens for Health, Inc. CurrentSince Dec 9, 2023 Accepting new patients
Isabella Citizens for Health Inc CurrentSince Dec 9, 2023 Accepting new patients
Isabella Citizens for Health Inc Current Accepting new patients

Locations

2790 Health Pkwy
Mt Pleasant, MI 48858
Phone (989) 779-5270

Interoperability endpoints

  • Direct secure messaging: kimberly.mcbryde.p1@direct.isabellahealth.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1902476377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 HEALTH PKWY",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488586934",
            "telephone_number": "989-779-5642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 HEALTH PKWY",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488586934",
            "telephone_number": "989-779-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBRYDE",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801110496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "BENOIT",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mt Pleasant, MI

Sources for this page

Verify at the official NPI Registry.