Mercedita Villar Kimbrough, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2009038441 Issued in MO

Practice address

1 CVS Dr
Woonsocket, RI 02895-6146

Phone

(866) 389-2727

NPI assigned

Dec 15, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mkimgrough@landmarkhealth-direct.org
• Direct secure messaging: mercedita.kimbrough.1@33202.direct.athenahealth.com
• Direct secure messaging: mkimbrough@landmarkhealth-direct.org

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.

• KS Urgent Care Center of Kansas City LLC

  • Urgent Care Clinic/Center
  • Kansas City, KS
  • NPI 1174562052
  NPD (past)
• PS Urgent Care Center Plus, P.a.

  • Urgent Care Clinic/Center
  • Kansas City, KS
  • NPI 1275779233
  NPD (past)

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

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1053640342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBROUGH",
        "first_name": "MERCEDITA",
        "middle_name": "VILLAR",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-15",
        "last_updated": "2021-10-19",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2009038441",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "2009038441",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pervez A Khatib, MD
• Catherine Ndagire Kigonya, M.D
• Brian Patrick Kiley, OD
• Bethany Killian, LCSW
• Charles J Kim, MD
• Joanna Jean King, MS CCC SLP
• Malcolm M Kirk, MD
• Dennis William Kirsten, DC, NP-C
• Christopher Kishfy, FNP
• Kiskeya Translations, Interpretations, & Support Services LLC

• Family Nurse Practitioner in Woonsocket, RI
• Providers in Woonsocket, RI by specialty
• Family Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.