KIMBERLY J PATRICK (LCSW) – Clinical Social Worker, NPI 1629612759

KIMBERLY J PATRICK (LCSW) is a healthcare provider. based in Meadowview, Virginia. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 0904011342 (VA). The NPI Number for KIMBERLY J PATRICK (LCSW) is 1629612759

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
KIMBERLY J PATRICK (LCSW)
NPI
1629612759
Phone
(276) 492-9985
Address
30371 Oxford Ave
Enumeration Date
1 November 2019
Last Update Date
26 February 2026

Doctor Profile

Medical School Name
EAST TENNESSEE STATE UNIVERSITY QUILLEN COLLEGE OF MEDICINE
Secondary Phone
2766695179
Graduation Year
2016 (10 years ago)
PAC ID
7214365782
Group Practice PAC ID
4880502707
Professional Enrollment ID
I20200316001506
Address ID
VA242013655BR2195XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness85
Years active:6State licenses:1Digital endpointsOther names

2,023 CLINICAL SOCIAL WORKER in VA

Provider Addresses for KIMBERLY J PATRICK (LCSW)

  • 30371 Oxford Ave

    Meadowview, VA 243613917

    Phone: (276) 492-9985

    Type: Location

  • PO BOX 646

    EMORY, VA 243270646

    Phone: (276) 492-9985

    Type: Mailing

  • 2195 EUCLID AVE

    BRISTOL, VA 24201

    Phone: (276) 669-5179

    Fax: (276) 466-8870

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-03-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200316001506IClinical Social WorkerVATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 24361)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4880502707View full group profile
NameSpecialtyState
Family PracticeVA
Nurse PractitionerVA
Family Practice, Addiction Medicine, General PracticeVA
-VA
General PracticeVA
Clinical Social WorkerCO
Pediatric MedicineVA
Nurse PractitionerVA
Clinical Social WorkerVA
Internal MedicineVA

Reviews

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Frequently asked questions

How is KIMBERLY J PATRICK (LCSW) identified in CMS data?
CMS-hosted NPPES data lists KIMBERLY J PATRICK (LCSW) with NPI 1629612759.
Is KIMBERLY J PATRICK (LCSW) listed as active for patients and plans?
The listing shows KIMBERLY J PATRICK (LCSW) as active in the NPI system.
What is KIMBERLY J PATRICK (LCSW)'s specialty?
The listing groups KIMBERLY J PATRICK (LCSW) with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What area does KIMBERLY J PATRICK (LCSW) serve?
KIMBERLY J PATRICK (LCSW)'s listing highlights Meadowview, Virginia; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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