Kimberley Roberts, PMHCNS-BC

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

R028815 Issued in ME

Practice address

53 Fremont St
Machias, ME 04654-1320

Phone

(207) 255-3400

NPI assigned

Jul 6, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1083645873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BOYNTON ST",
            "city": "EASTPORT",
            "state": "ME",
            "postal_code": "046311306",
            "telephone_number": "207-255-3400",
            "fax_number": "207-255-3401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 FREMONT ST",
            "city": "MACHIAS",
            "state": "ME",
            "postal_code": "046541320",
            "telephone_number": "207-255-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KIMBERLEY",
        "credential": "PMHCNS-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "ME",
            "license": "R028815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258550099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Respectful Living, LLC
• Jason T Rexroad, M.D.
• Joshua Reynolds, M.D.
• David C Rioux, D.O.
• Rite Aid of Maine Inc
• Lynda D. Roberts, MHRT-CSP
• Katie Robinson Call, LSW-C BHP
• Roque Bluffs School Department
• Karen Ryla, LCPC, NCC
• Donna K. Salisbury, L.C.S.W.

• Psychiatric/Mental Health Clinical Nurse Specialist in Machias, ME
• Providers in Machias, ME by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; 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.