Individual provider Active NPI

Kimberly Ann Wagner-Rohrs, LCSW

  • Clinical Social Worker
  • St Petersburg, FL
National Provider Identifier
1992932578
Registry record updated Nov 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9007 Issued in FL
Practice address
3082 Granville CT N
St Petersburg, FL 33704-2025
Phone
(727) 251-0280
NPI assigned
Jun 22, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2009

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 9007 FL Primary

Addresses

Primary practice location

3082 Granville CT N
St Petersburg, FL 33704-2025

Mailing address

3082 Granville CT N
St Petersburg, FL 33704-2025
Phone (727) 251-0280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20091203000151 FL Practitioner - Clinical Social Worker 6406995513 Reassigns benefits to 1 organization
Practice locations: Dunedin, FL; Pinellas Park, FL; Safety Harbor, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cotler Healthcare and Development IncGroup PAC ID 0143121145, 25 clinicians

Practice addresses (Care Compare)

1410 Dr ML King Jr St N
Safety Harbor, FL 34695-3303
Phone (561) 249-7835

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9007FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cotler Healthcare & Development Inc. CurrentSince Aug 1, 2018 Accepting new patients

Locations

1351 San Christopher Dr
Dunedin, FL 34698
Phone (727) 736-1421

901 S 62nd Ave
Hollywood, FL 33023
Phone (954) 893-0109

9835 Lake Worth Rd
Ste 16179
Lake Worth, FL 33467

1410 Ml King St N
Safety Harbor, FL 34695

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": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258934400000",
    "number": "1992932578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3082 GRANVILLE CT N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337042025",
            "telephone_number": "727-251-0280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3082 GRANVILLE CT N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337042025",
            "telephone_number": "727-251-0280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER-ROHRS",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2009-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "9007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.