Individual provider Active NPI

Kimberly S. Macdermott, APRN

  • Family Nurse Practitioner
  • North Conway, NH
National Provider Identifier
1003240359
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11013672 Issued in FL
Practice address
3073 White Mountain Hwy
North Conway, NH 03860-7101
Phone
(603) 356-5472
Fax
(603) 356-9647
NPI assigned
Aug 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11013672 FL Primary
Family Nurse Practitioner 363LF0000X NP 0990840 CO
Family Nurse Practitioner 363LF0000X 074932-23 NH

Addresses

Primary practice location

3073 White Mountain Hwy
North Conway, NH 03860-7101

Mailing address

3073 White Mountain Hwy
North Conway, NH 03860-7101
Phone (603) 356-5472

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131003000428 CO Practitioner - Nurse Practitioner 6204060338 Reassigns benefits to 2 organizations
I20211124002191 FL Practitioner - Nurse Practitioner 6204060338 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Global Physician Network LLC Series IGroup PAC ID 7214202365, 40 clinicians

Practice addresses (Care Compare)

1700 S Tamiami TRL
Sarasota, FL 34239-3509
Phone (941) 917-9000

Hospital & facility affiliations

  • Montrose Regional Health Hospital, Montrose, CO, CCN 060006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP 0990840COMDFamily Nurse Practitioner
11013672FLMDFamily Nurse Practitioner
074932-23NHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado West Emergency Physicians, LLC CurrentSince Jun 22, 2014 Accepting new patients
Denver Health and Hospital Authority CurrentSince Sep 1, 2013 Accepting new patients
Global Physician Network LLC Series II CurrentSince Dec 1, 2024 Accepting new patients
Denver Health and Hospital Authority CurrentSince Sep 1, 2013 Accepting new patients
Global Physician Network LLC Series I CurrentSince Dec 1, 2024 Accepting new patients
Cedar Point Health LLC Past Accepting new patients

Locations

Dept 0861
Denver, CO 80256
Phone (970) 298-1977

777 Bannock St
Denver, CO 80204

2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009

6331 S Tamiami Trl
Sarasota, FL 34231
Phone (941) 917-5678

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1377129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1003240359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3073 WHITE MOUNTAIN HWY",
            "city": "NORTH CONWAY",
            "state": "NH",
            "postal_code": "038607101",
            "telephone_number": "603-356-5472",
            "fax_number": "603-356-9647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3073 WHITE MOUNTAIN HWY",
            "city": "NORTH CONWAY",
            "state": "NH",
            "postal_code": "038607101",
            "telephone_number": "603-356-5472",
            "fax_number": "603-356-9647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDERMOTT",
        "first_name": "KIMBERLY",
        "middle_name": "S.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-22",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11013672",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "NP 0990840",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "074932-23",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Conway, NH

Sources for this page

Verify at the official NPI Registry.