Individual provider Active NPI

Kimberly M McIntosh

  • Family Nurse Practitioner
  • Wimberley, TX
National Provider Identifier
1003785932
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1216585 Issued in TX
Practice address
555 Ranch Road 3237
Wimberley, TX 78676-5311
Phone
(512) 847-5540
NPI assigned
Oct 30, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1216585 TX Primary

Addresses

Primary practice location

555 Ranch Road 3237
Wimberley, TX 78676-5311

Mailing address

1108 Lavaca St Ste 110-320
Austin, TX 78701-2172
Phone (512) 477-4088

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
I20251114002698 TX Practitioner - Nurse Practitioner 7517458755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1108 Lavaca St
Suite 110 320
Austin, TX 78701-2110

4810 Spicewood Springs Rd
BLDG B
Austin, TX 78759-7838

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1216585TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Geriatric Specialists, PLLC CurrentSince Nov 7, 2025 Accepting new patients
Hni Medical Services PastSince Nov 8, 2025 Accepting new patients

Locations

1108 Lavaca St
Ste 110320
Austin, TX 78701
Phone (512) 482-0390

11406 Rustic Rock Dr
Austin, TX 78750
Phone (512) 251-3915

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18292/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kimberly.mcintosh.1@25850.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/25850/brand/1/csg/1/fhir/r4

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": "1761782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1003785932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 LAVACA ST STE 110-320",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787012172",
            "telephone_number": "512-477-4088",
            "fax_number": "512-482-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 RANCH ROAD 3237",
            "city": "WIMBERLEY",
            "state": "TX",
            "postal_code": "786765311",
            "telephone_number": "512-847-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-30",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1216585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wimberley, TX

Sources for this page

Verify at the official NPI Registry.