Individual provider Active NPI

Kimberly C. L'Heureux, NPP

  • Psychiatric/Mental Health Nurse Practitioner
  • Malta, NY
National Provider Identifier
1063724045
Registry record updated Nov 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
401282 Issued in NY
Practice address
2911 Route 9
Suite #2
Malta, NY 12020-3329
Phone
(518) 871-1258
Fax
(578) 871-1265
NPI assigned
Jul 8, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 401282 NY Primary

Addresses

Primary practice location

2911 Route 9
Suite #2
Malta, NY 12020-3329

Mailing address

PO Box 419
Saratoga Springs, NY 12866-0419
Phone (518) 871-1258

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20170427001479 NY Practitioner - Nurse Practitioner 8729365853 Practice locations: Malta, NY

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2911 Route 9
Suite 2
Malta, NY 12020-3975
Phone (518) 871-1258

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oberg Psychiatric Nurse Practitioner, PLLC PastSince Oct 3, 2017 Accepting new patients

Organizations & group practices 1

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": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1063724045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128660419",
            "telephone_number": "518-871-1258",
            "fax_number": "518-871-1265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 ROUTE 9",
            "address_2": "SUITE #2",
            "city": "MALTA",
            "state": "NY",
            "postal_code": "120203329",
            "telephone_number": "518-871-1258",
            "fax_number": "578-871-1265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "L'HEUREUX",
        "first_name": "KIMBERLY",
        "middle_name": "C.",
        "credential": "NPP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-08",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "401282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malta, NY

Sources for this page

Verify at the official NPI Registry.