Individual provider Active NPI

Kimberly Eubanks, FNP-BC

  • Family Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1093303042
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-NP211522 Issued in GA
Practice address
12280 Lake Underhill Rd
Orlando, FL 32825-5009
Phone
(866) 389-2727
Fax
(401) 287-0316
NPI assigned
Jan 5, 2021
Last updated
Oct 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 15496 CT
Family Nurse Practitioner 363LF0000X 95025872 CA
Family Nurse Practitioner 363LF0000X APRN-CNP86795 NM
Family Nurse Practitioner 363LF0000X CNP231653 ME
Family Nurse Practitioner 363LF0000X RN10017316 MA
Family Nurse Practitioner 363LF0000X AP61579027 WA
Family Nurse Practitioner 363LF0000X APRN-NP211522 GA Primary
Family Nurse Practitioner 363LF0000X 35105 TN
Family Nurse Practitioner 363LF0000X C-RXN.0100421-C-NP CO
Family Nurse Practitioner 363LF0000X 294005 AZ
Family Nurse Practitioner 363LF0000X APRN.CNP.0043617 OH
Family Nurse Practitioner 363LF0000X 5018570 NC
Family Nurse Practitioner 363LF0000X APRN11033789 FL

Addresses

Primary practice location

12280 Lake Underhill Rd
Orlando, FL 32825-5009

Mailing address

1845 Azalea Springs TRL
Roswell, GA 30075-1858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210120003416 GA Practitioner - Nurse Practitioner 7416361159 Reassigns benefits to 1 organization
I20231211001498 NC Practitioner - Nurse Practitioner 7416361159 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hopscotch Primary Care PLLCGroup PAC ID 7911173380, 47 clinicians

Practice addresses (Care Compare)

104 N Main St
Weaverville, NC 28787-8230
Phone (828) 645-7974

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN-NP211522GAMDFamily Nurse Practitioner
35105TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dry Ridge Family Medicine PLLC CurrentSince Jul 2, 2025 Accepting new patients
Alpha Family Medicine Inc CurrentSince Jan 15, 2021 Accepting new patients
Hopscotch Primary Care, PLLC CurrentSince Jul 2, 2025 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 23, 2023 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 23, 2023 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Raleigh Durham Medical Group PA Past Accepting new patients
Hopscotch Primary Care Group, PA Past Accepting new patients

Locations

480 N Main St
Ste 202
Alpharetta, GA 30009
Phone (678) 433-9735

6 Brooklet St
Asheville, NC 28801
Phone (828) 250-0898

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

269 S Main St
Norwood, NC 28128
Phone (704) 474-3171

104 N Main St
Weaverville, NC 28787
Phone (817) 966-0621

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26812/brand/6/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/9927/brand/1/csg/1/fhir/r4
  • Direct secure messaging: keubanks2705608@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 8

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1093303042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 AZALEA SPRINGS TRL",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300751858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12280 LAKE UNDERHILL RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328255009",
            "telephone_number": "866-389-2727",
            "fax_number": "401-287-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUBANKS",
        "first_name": "KIMBERLY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-05",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "15496",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95025872",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "APRN-CNP86795",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP231653",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN10017316",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61579027",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP211522",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "35105",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "C-RXN.0100421-C-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "294005",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0043617",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5018570",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11033789",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.