Joy Kimberly Higginbotham, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

NP 06404 Issued in OH

Practice address

204 Patrick Ave
Urbana, OH 43078-2302

Phone

(937) 484-6157

Fax

(937) 484-6181

NPI assigned

Dec 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412899200000",
    "number": "1053476523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 PATRICK AVE",
            "city": "URBANA",
            "state": "OH",
            "postal_code": "430782302",
            "telephone_number": "937-484-6157",
            "fax_number": "937-484-6181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 PATRICK AVE",
            "city": "URBANA",
            "state": "OH",
            "postal_code": "430782302",
            "telephone_number": "937-484-6157",
            "fax_number": "937-484-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGGINBOTHAM",
        "first_name": "JOY",
        "middle_name": "KIMBERLY",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2014-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "NP 06404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2285790",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Nurse Practitioner in Urbana, OH
• Providers in Urbana, OH by specialty
• Pediatric Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; 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.