Active NPI
Kim A. Ross, LCSW
- Social Worker
- Winter Haven, FL
National Provider Identifier
1962548453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- SW0004580
- Practice address
- 1201 1St St S
Winter Haven, FL 33880-3904 - Phone
- (863) 294-7062
- Fax
- (863) 294-7064
- NPI assigned
- Jan 30, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | SW0004580 | FL | Primary |
Addresses
Primary practice location
1201 1St St S
Winter Haven, FL 33880-3904
Mailing address
PO Box 10744
Clearwater, FL 33757-8744
Phone (727) 532-1355
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
| License | State | Type | Specialty |
|---|---|---|---|
| SW0004580 | FL | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John P McDonough III | Current | Accepting new patients |
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491523200000",
"number": "1962548453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10744",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337578744",
"telephone_number": "727-532-1355",
"fax_number": "727-266-4943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 1ST ST S",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338803904",
"telephone_number": "863-294-7062",
"fax_number": "863-294-7064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "KIM",
"middle_name": "A.",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-30",
"last_updated": "2017-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "FL",
"license": "SW0004580",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winter Haven, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.