Individual provider Active NPI

Kimberly Anne Lucas Slimane, N.P.

  • Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1003042573
Registry record updated Jul 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP118333 Issued in TX
Practice address
21 Spurs LN Ste 230B
San Antonio, TX 78240-1671
Phone
(210) 690-7400
Fax
(210) 690-7405
NPI assigned
Jun 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 707989 TX
Nurse Practitioner 363L00000X AP118333 TX Primary

Addresses

Primary practice location

21 Spurs LN Ste 230B
San Antonio, TX 78240-1671

Mailing address

21 Spurs LN
Ste 230B
San Antonio, TX 78240-1671
Phone (210) 690-7400

Other identifiers 1

IdentifierTypeStateIssuer
296559201MedicaidTX

Other names 1

  • Ms. Kimberly Anne Lucas Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110110000751 TX Practitioner - Nurse Practitioner 9830388644 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP118333TXMDNurse Practitioner
707989TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charles J. Burch, M.D., P.a. CurrentSince Jan 11, 2011 Accepting new patients
Texas Ips LLC CurrentSince Apr 15, 2012 Accepting new patients

Locations

34910 Interstate 10 W
Boerne, TX 78006
Phone (210) 396-7609

34910 Interstate 10 W
Ste 601
Boerne, TX 78006
Phone (830) 248-1207

1434 E Sonterra Blvd
Ste 210
San Antonio, TX 78258
Phone (210) 481-3119

12446 West Ave
Ste 200
San Antonio, TX 78216
Phone (210) 690-0230

21 Spurs Ln
Ste 230B
San Antonio, TX 78240

4499 Medical Dr
Ste 150
San Antonio, TX 78229
Phone (210) 614-8181

4458 Medical Dr
Ste 505
San Antonio, TX 78229

4499 Medical Dr
#150
San Antonio, TX 78229
Phone (210) 614-8181

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DCJJCA/Endpoint/DCJJCA

Organizations & group practices 2

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": "1244592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438128000000",
    "number": "1003042573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 SPURS LN",
            "address_2": "STE 230B",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401671",
            "telephone_number": "210-690-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SPURS LN STE 230B",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401671",
            "telephone_number": "210-690-7400",
            "fax_number": "210-690-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS SLIMANE",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-10",
        "last_updated": "2015-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "707989",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP118333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "296559201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "LUCAS",
            "middle_name": "ANNE",
            "prefix": "MS.",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.