Individual provider Active NPI

Kimberly McConnell, CNM

  • Advanced Practice Midwife
  • Panama City, FL
National Provider Identifier
1003396672
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
Practice address
103 E 23Rd St
Panama City, FL 32405-4501
Phone
(850) 769-0338
Fax
(850) 640-2195
NPI assigned
Aug 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X APRN11004896 FL
Advanced Practice Midwife 367A00000X Primary

Addresses

Primary practice location

103 E 23Rd St
Panama City, FL 32405-4501

Mailing address

103 E 23Rd St
Panama City, FL 32405-4501
Phone (850) 769-0338

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
I20200114001338 FL Practitioner - Certified Nurse Midwife (CNM) 4587916028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.76 of 100Reported as group
Quality
84.84
Promoting interoperability
100
Improvement activities
40
Cost
77.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Woman Care, LLC CurrentSince Dec 17, 2019 Accepting new patients
Womencare PA Past Accepting new patients

Locations

2815 S Seacrest Blvd
Ste 112
Boynton Beach, FL 33435
Phone (561) 368-0233

199 S US Highway 17
East Palatka, FL 32131
Phone (386) 325-6699

103 E 23rd St
Panama City, FL 32405
Phone (850) 769-0338

1002 N Arnold Rd
Unit 303
Panama City Beach, FL 32413
Phone (850) 769-0338

Interoperability endpoints

  • Direct secure messaging: kimberly.mcconnell.1@2183.direct.athenahealth.com

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": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1003396672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 E 23RD ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054501",
            "telephone_number": "850-769-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 E 23RD ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054501",
            "telephone_number": "850-769-0338",
            "fax_number": "850-640-2195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNELL",
        "first_name": "KIMBERLY",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-14",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "FL",
            "license": "APRN11004896",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.