Kimberly Jean Bundridge, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

COA .17589-NP Issued in OH

Practice address

3500 Kolbe Rd
Palliative Care Dept
Lorain, OH 44053-1632

Phone

(440) 934-1458

Fax

(440) 960-4922

NPI assigned

Jun 2, 2015

Last updated

Sep 11, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
• Fairview Hospital Hospital, Cleveland, OH, CCN 360077

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Medicare reassignment Care Compare group NPD
• Mercy Health Physicians Lorain, LLC

  • Family Medicine Physician
  • Lorain, OH
  • NPI 1023347192
  Medicare reassignment NPD
• Mercy Health-Regional Medical Center LLC

  • Radiation Oncology Physician
  • Lorain, OH
  • NPI 1558527184
  Medicare reassignment NPD
• Mercy Health Physicians, Lorain, LLC

  dba Mercy Health - Orthopedics and Sports Medicine

  • Durable Medical Equipment & Medical Supplies
  • Oberlin, OH
  • NPI 1730724147
  NPD
• Mercy Health-Regional Medical Center LLC

  dba Mercy Health New Life Hospice

  • Community Based Hospice Care Agency
  • Lorain, OH
  • NPI 1124056874
  NPD
• Mercy Health-Regional Medical Center LLC

  dba Harness Health Pharmacy #170

  • Community/Retail Pharmacy
  • Lorain, OH
  • NPI 1942718713
  NPD

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

• Fairview Hospital

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1215989611
  Care Compare affiliation
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Care Compare affiliation

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441929600000",
    "number": "1073993317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 KOLBE RD",
            "address_2": "PALLIATIVE CARE DEPT",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440531632",
            "telephone_number": "440-934-1458",
            "fax_number": "440-960-4922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 KOLBE RD",
            "address_2": "PALLIATIVE CARE DEPT",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440531632",
            "telephone_number": "440-934-1458",
            "fax_number": "440-960-4922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNDRIDGE",
        "first_name": "KIMBERLY",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-02",
        "last_updated": "2015-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA .17589-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0207207",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lyn Bruno, CDCA
• Scott Bryan, AT
• Amirah Bryant, CDCA
• Yolanda Bryant
• Julie Renee Buck, LPN
• Alvina Faye Burdette
• Victoria Burdette, PHARMD
• Brenda Burgos
• Marileisy Burgos
• Shelley Annetteq Burke, M.D.

• Family Nurse Practitioner in Lorain, OH
• Providers in Lorain, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.