Kimberly D. Roth, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

120906 Issued in MA

Practice address

16 Samoset St
Plymouth, MA 02360-4544

Phone

(508) 388-4211

NPI assigned

Aug 27, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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.

• Hyannis Family Medical Care P.C.

  • Primary Care Clinic/Center
  • Hyannis, MA
  • NPI 1811131576
  NPD (past)

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513123200000",
    "number": "1962836932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 696",
            "city": "EAST FALMOUTH",
            "state": "MA",
            "postal_code": "025360696",
            "telephone_number": "508-388-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 SAMOSET ST",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604544",
            "telephone_number": "508-388-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "KIMBERLY",
        "middle_name": "D.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-27",
        "last_updated": "2017-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "120906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason B. Rose, MS, RCEP
• Lorinda M Rose
• Samuel T Rosenbach, DPT
• Ross S Ajemian DDS
• Kara Hope Ross, MS CCC-SLP
• Victoria Roth, DC
• Abigail Caroline Roux, RN
• Ruth C. Rowbotham, PSY.D.
• Jacob Glenn Rowland, PT, DPT
• Sarah Royle

• Clinical Social Worker in Plymouth, MA
• Providers in Plymouth, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.