Individual provider Active NPI

Kimberly Gayle Geib, ARNP

  • Adult Health Nurse Practitioner
  • Fernandina Beach, FL
National Provider Identifier
1063421063
Registry record updated Feb 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP1121982 Issued in FL
Practice address
1620 Nectarine St
Fernandina Beach, FL 32034-4724
Phone
(904) 548-1860
Fax
(904) 277-7283
NPI assigned
Aug 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP1121982 FL Primary

Addresses

Primary practice location

1620 Nectarine St
Fernandina Beach, FL 32034-4724

Mailing address

PO Box 517
Fernandina Beach, FL 32035-0517
Phone (904) 548-1800

Other identifiers 1

IdentifierTypeStateIssuer
304015100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20140708001080 FL Practitioner - Nurse Practitioner 8628293636 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health CurrentSince Mar 9, 2014 Accepting new patients
Florida Department of Health CurrentSince Mar 9, 2014 Accepting new patients

Locations

45377 Mickler St
Callahan, FL 32011
Phone (904) 320-6010

30 S 4th St
Fernandina Beach, FL 32034
Phone (904) 261-6191

1620 Nectarine St
Fernandina Beach, FL 32034
Phone 90454818005210

Organizations & group practices 2

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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360022400000",
    "number": "1063421063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 517",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320350517",
            "telephone_number": "904-548-1800",
            "fax_number": "904-277-7286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 NECTARINE ST",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320344724",
            "telephone_number": "904-548-1860",
            "fax_number": "904-277-7283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEIB",
        "first_name": "KIMBERLY",
        "middle_name": "GAYLE",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2013-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP1121982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304015100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fernandina Beach, FL

Sources for this page

Verify at the official NPI Registry.