Kimberly Allen
Individual provider Active NPI Family Nurse Practitioner · Espanola, NM
NPI 1033640263 · NPPES record last updated Mar 21, 2017
Key facts
- NPI
- 1033640263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- CNP03174 (NM)
- Practice address
- 1010 Spruce St
Espanola, NM 87532-2724 - Phone
- (505) 753-7111
- NPI assigned
- Mar 21, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 8
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dhew Ind HLTH SV HLTH SVS and MNTL HLTH Adm
Practice addresses (Care Compare)
4212 N 16TH St
Phoenix, AZ 85016-5319
Phone (602) 263-1200
Hospital & facility affiliations
- Phoenix Indian Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (4 enrollments) in NM, TX, CO, AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170407000412 | NM | Practitioner - Nurse Practitioner | 2466738372 | Reassigns benefits to 2 organizations |
| I20230302002262 | TX | Practitioner - Nurse Practitioner | 2466738372 | Reassigns benefits to 1 organization |
| I20240320003416 | CO | Practitioner - Nurse Practitioner | 2466738372 | |
| I20240402002264 | AZ | Practitioner - Nurse Practitioner | 2466738372 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CNP03174 | NM | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Presbyterian Healthcare Services | Current |
Accepting new patients | |
| Signify Health, LLC | Current |
Accepting new patients | |
| Signify Health Medical Associates of Colorado, PLLC. | Current |
Accepting new patients | |
| Presbyterian Healthcare Services | Current |
Accepting new patients | |
| Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm | Current |
Accepting new patients | |
| Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm | Current |
Accepting new patients | |
| Presbyterian Healthcare Services | Current | Accepting new patients |
Locations
2705 S Alma School Rd
Chandler, AZ 85286
Phone (480) 820-7246
4212 N 16th St
Phoenix, AZ 85016
Phone (602) 248-4187
7900 E Union Ave
Ste 1100
Denver, CO 80237
Phone (469) 466-7420
8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200
500 Marquette Ave NW
Ste 1200
Albuquerque, NM 87102
Phone (505) 295-6685
6400 Paseo del Norte NE
Albuquerque, NM 87113
Phone (505) 596-2100
2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577
1010 Spruce St
Espanola, NM 87532
Phone (505) 367-0340
4801 Beckner Rd
Santa Fe, NM 87507
Phone (505) 772-1234
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | CNP03174 | NM | Yes |
Addresses
Primary practice location
1010 Spruce St
Espanola, NM 87532-2724
Mailing address
115 Valley Dr
Santa Fe, NM 87501-1163
Other providers in Espanola, NM
- Albuquerque Vamc
- Christopher Alcala
- Jessica Lynn Alcon-Romero
- Nicole Alire
- Haley Allen
- Francisca Nwamaka Alozie
- Mildred Altamira
- Erika Alvarado
- Ana M Guldan, Ma, LPCC, LLC
- Cruz Anaya
All providers in Espanola, NM · Family Nurse Practitioner in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.