NPIMap

Individual provider Active NPI

Kimberly Proos Parrillo, N.P.

  • Family Nurse Practitioner
  • Kennebunk, ME
National Provider Identifier
1073067146
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP231162 Issued in ME
Practice address
2 Livewell Dr
Kennebunk, ME 04043-6762
Phone
(207) 467-8988
NPI assigned
Aug 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN1019282 DC
Family Nurse Practitioner 363LF0000X CNP231162 ME Primary

Addresses

Primary practice location

2 Livewell Dr
Kennebunk, ME 04043-6762

Mailing address

2 Livewell Dr
Kennebunk, ME 04043-6762

Other names 1

  • Kimberly Michele Proos Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, ME2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161103000047 DC Practitioner - Nurse Practitioner 7517245038 Reassigns benefits to 2 organizations
I20231020000571 ME Practitioner - Nurse Practitioner 7517245038 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

2 Livewell Dr
Kennebunk, ME 04043-6762
Phone (207) 467-8988

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN1019282DCMDFamily Nurse Practitioner
CNP231162MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth Current Accepting new patients
MGMC, LLC CurrentSince Sep 8, 2016 Accepting new patients
Children's Hospital CurrentSince May 25, 2022 Accepting new patients
Mainehealth CurrentSince Sep 11, 2023 Accepting new patients
Medstar Medical Group II LLC CurrentSince Sep 8, 2016 Accepting new patients
Mainehealth CurrentSince Sep 11, 2023 Accepting new patients
Children's Hospital Current Accepting new patients
Children's Hospital CurrentSince May 25, 2022 Accepting new patients
Mainehealth Past Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

3800 Reservoir Rd NW
Bldg 6TH
Washington, DC 20007
Phone (202) 444-9183

3800 Reservoir Rd NW
Washington, DC 20007
Phone (202) 687-2203

2 Livewell Dr
Kennebunk, ME 04043
Phone (207) 467-6900

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

Interoperability endpoints

  • Direct secure messaging: kparrillo595816@direct.mmc.mainehealth.org

Organizations & group practices 9

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.

Hospital & facility affiliations 37

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1470441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1073067146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 LIVEWELL DR",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040436762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 LIVEWELL DR",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040436762",
            "telephone_number": "207-467-8988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARRILLO",
        "first_name": "KIMBERLY",
        "middle_name": "PROOS",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-06",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "RN1019282",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP231162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "PROOS",
            "middle_name": "MICHELE",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kennebunk, ME

Sources for this page

Verify at the official NPI Registry.