Kimberly Jean Ellis-Koceja

Primary specialty

Attendant Care ProviderTaxonomy code 3747A0650X

Practice address

4952 Grassy Pond Rd
Chipley, FL 32428-5547

Phone

(850) 596-4137

NPI assigned

Aug 29, 2019

Last updated

Aug 29, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1567036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1013565399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4523 NORTHSHORE RD",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324443478",
            "telephone_number": "850-596-4137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4952 GRASSY POND RD",
            "city": "CHIPLEY",
            "state": "FL",
            "postal_code": "324285547",
            "telephone_number": "850-596-4137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS-KOCEJA",
        "first_name": "KIMBERLY",
        "middle_name": "JEAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-29",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary William Dickson, ARNP-C
• Dream Medical LLC (Spine & Neuro Pain Specialists)
• Frances Duffek, DMD
• Lori Dawn Edenfield, ARNP BC
• Rhyne Elliott
• Eye Center of North Florida, P.a.
• Family Care Associates of NW Florida
• Matthew R Fischer, DPT
• Florida Department of Health (Washington County Health Department)
• Florida Woman Care, LLC

• Attendant Care Provider in Chipley, FL
• Providers in Chipley, FL by specialty
• Attendant Care Provider in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.