Kimberly Marie Niemeyer

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

5014147 Issued in NC

Practice address

195 W Illinois Ave
Southern Pines, NC 28387-5808

Phone

(910) 692-2444

NPI assigned

Mar 2, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Sandhills Pediatrics

  • Pediatrics Physician
  • Winston Salem, NC
  • NPI 1043172471
  NPD (past)
• Sandhills Pediatrics

  • Pediatrics Physician
  • Southern Pines, NC
  • NPI 1114998150
  NPD (past)

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

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1083209001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 W ILLINOIS AVE",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283875808",
            "telephone_number": "910-692-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 W ILLINOIS AVE",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283875808",
            "telephone_number": "910-692-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMEYER",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-02",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5014147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Nettnin
• New Town Center Pharmacy Inc
• Autumn Eau Claire Newberry
• Myroslava Niameshchuk
• Nicole Sutton Behavioral Therapy
• North Carolina CVS Pharmacy LLC
• Nourished Roots Therapy Services
• Oettinger and Associates, PLLC
• Olsen & Olsen PLLC
• Rodolfo De Lossantos Ongjoco Jr., MD

• Pediatric Nurse Practitioner in Southern Pines, NC
• Providers in Southern Pines, NC by specialty
• Pediatric Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.