Active NPI
Kimberly Angela Vankirk, LCSW
- Clinical Social Worker
- South Lake Tahoe, CA
National Provider Identifier
1962746065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW68107
- Practice address
- 2201 South Ave
South Lake Tahoe, CA 96150-7025 - Phone
- (530) 543-5623
- Fax
- (530) 541-5738
- NPI assigned
- Nov 15, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW68107 | CA | Primary |
Addresses
Primary practice location
2201 South Ave
South Lake Tahoe, CA 96150-7025
Mailing address
PO Box 3231
Stateline, NV 89449-3231
Phone (530) 721-7716
Other names 1
- Kimberly Angela Kilgore
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 |
|---|---|---|---|
| LCSW68107 | CA | MD | Clinical Social Worker |
| 68107 | CA | MD | Ambulatory Care Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674172800000",
"number": "1962746065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3231",
"city": "STATELINE",
"state": "NV",
"postal_code": "894493231",
"telephone_number": "530-721-7716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2201 SOUTH AVE",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "961507025",
"telephone_number": "530-543-5623",
"fax_number": "530-541-5738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANKIRK",
"first_name": "KIMBERLY",
"middle_name": "ANGELA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-15",
"last_updated": "2023-01-20",
"certification_date": "2023-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW68107",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KIMBERLY",
"last_name": "KILGORE",
"middle_name": "ANGELA",
"credential": "LCSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in South Lake Tahoe, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.