Individual provider Active NPI

Kimberly Venella

  • Children's Hospital
  • Philadelphia, PA
National Provider Identifier
1053786731
Registry record updated Dec 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's HospitalTaxonomy code 282NC2000X
License
SP015420 Issued in PA
Practice address
3400 Civic Center Blvd
Philadelphia, PA 19104-5127
Phone
(215) 590-1000
NPI assigned
Dec 7, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Hospital 282NC2000X SP015420 PA Primary

Addresses

Primary practice location

3400 Civic Center Blvd
Philadelphia, PA 19104-5127

Mailing address

3400 Civic Center Blvd
Philadelphia, PA 19104-5127

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20240705001541 PA Practitioner - Nurse Practitioner 4082158761 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP015420PAMDChildren's Hospital

Practice roles

OrganizationSpecialtyStatusNew patients
Childen'S Health Care Associates Inc. CurrentSince Apr 25, 2024 Accepting new patients
Childrens Health Care Associates CurrentSince Apr 25, 2024 Accepting new patients
Childrens Health Care Associates, Inc Current Accepting new patients
Childrens Health Care Associates of New Jersey PC Past Accepting new patients

Locations

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

2929 Arch St
Fl 12
Philadelphia, PA 19104

Organizations & group practices 4

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": "1449446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449446400000",
    "number": "1053786731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-590-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENELLA",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-07",
        "last_updated": "2015-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282NC2000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Children",
            "state": "PA",
            "license": "SP015420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.