Individual provider Active NPI

Krista Lee Barber

  • Clinical Social Worker
  • St Augustine, FL
National Provider Identifier
1942745997
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW11523 Issued in FL
Practice address
9 San Bartola Dr
St Augustine, FL 32086-5767
Phone
(904) 825-4500
Fax
(904) 825-3672
NPI assigned
Dec 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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 SW11523 FL Primary

Addresses

Primary practice location

9 San Bartola Dr
St Augustine, FL 32086-5767

Mailing address

7015 A C Skinner Pkwy Ste 1
Jacksonville, FL 32256-6932
Phone (904) 363-2113

Other practice location 1

1 Jarrett White Rd
Tripler Army Medical Center, HI 96859-5001
Phone (808) 433-2778

Other identifiers 2

IdentifierTypeStateIssuer
M7007OtherFLMEDICARE
WAD4UOtherFLFL BLUE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AZ, MA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20201029002879 FL Practitioner - Clinical Social Worker 3779993944 Reassigns benefits to 1 organization
I20240711003512 AZ Practitioner - Clinical Social Worker 3779993944 Reassigns benefits to 1 organization
I20250614000179 MA Practitioner - Clinical Social Worker 3779993944 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW11523FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince May 28, 2024 Accepting new patients

Locations

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

100 Cambridge St
Fl 14
Boston, MA 02114
Phone (617) 917-2389

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.

NPI Registry JSON

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

{
    "created_epoch": "1482969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1942745997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7015 A C SKINNER PKWY STE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566932",
            "telephone_number": "904-363-2113",
            "fax_number": "904-363-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 SAN BARTOLA DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865767",
            "telephone_number": "904-825-4500",
            "fax_number": "904-825-3672"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Jarrett White Rd",
            "address_purpose": "LOCATION",
            "city": "Tripler Army Medical Center",
            "state": "HI",
            "postal_code": "968595001",
            "country_code": "US",
            "telephone_number": "808-433-2778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARBER",
        "first_name": "KRISTA",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-29",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "M7007",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BLUE",
            "identifier": "WAD4U",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.