Kristin Elena Klimbal, APRN
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Spartanburg, SC
NPI 1083099857 · NPPES record last updated Apr 19, 2017
Key facts
- NPI
- 1083099857
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- APN.19918 RX (SC)
- Practice address
- 391 Serpentine Dr
Suite 400
Spartanburg, SC 29303-3096 - Phone
- (864) 560-7517
- Fax
- (864) 560-7520
- NPI assigned
- Jul 22, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 22
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Chestnut Hill Mental Health Center, Inc
Spartanburg Medical Center
Practice addresses (Care Compare)
1 Havenwood LN
Travelers Rest, SC 29690-9680
Phone (864) 834-8013
391 Serpentine Dr
Suite 400
Spartanburg, SC 29303-3081
Phone (864) 560-7517
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.7 of 100
- Quality
- 89.4
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170417002213 | SC | Practitioner - Nurse Practitioner | 2062798523 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APN.19918 RX | SC | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chestnut Hill Mental Health Center, Inc | Current | Accepting new patients | |
| Chestnut Hill Mental Health Center, Inc. | Current |
Accepting new patients | |
| Spartanburg Medical Center | Current |
Accepting new patients | |
| Spartanburg Medical Center | Current |
Accepting new patients | |
| Spartanburg Medical Center | Current | Accepting new patients | |
| Spartanburg Medical Center | Past | Accepting new patients |
Locations
2755 S Highway 14
Ste 1200D
Greer, SC 29650
Phone (864) 849-9333
853 N Church St
Ste 410A
Spartanburg, SC 29303
Phone (864) 560-6928
391 Serpentine Dr
Ste 400
Spartanburg, SC 29303
Phone (864) 560-7517
1 Havenwood Ln
Travelers Rst, SC 29690
Phone (864) 834-8013
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | APN.19918 RX | SC | Yes |
Addresses
Primary practice location
391 Serpentine Dr
Suite 400
Spartanburg, SC 29303-3096
Mailing address
PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NP3724 | Medicaid | SC |
Other providers in Spartanburg, SC
- Katelynn Amberly King
- Maria Lian King
- Joshua Lee Kingsmore
- Sommer Lane Kitchin
- Trevor Lee Klein
- Mareli Klopper
- Scott A Klosterman
- Donna Fossett Knight
- Edward Bert Knight III
- Robert Christopher Knight
All providers in Spartanburg, SC · Psychiatric/Mental Health Nurse Practitioner in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 19, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.