Individual provider Active NPI

Kimberly Anne Hammonds, DNP, RN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1093376832
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
27642 Issued in SC
Practice address
2000 Center Point Drive
Suite 2350
Columbia, SC 29210
NPI assigned
Jun 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 27642 SC Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2019022617 MO

Addresses

Primary practice location

2000 Center Point Drive
Suite 2350
Columbia, SC 29210

Mailing address

PO Box 514
Neosho, MO 64850-0514
Phone (417) 592-1667

Other practice location 1

3901 E 32nd St
Joplin, MO 64804-3312
Phone (417) 347-7567

Other practice location 2

530 E 34th St
Joplin, MO 64804-3926
Phone (417) 347-7630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20240701004173 SC Practitioner - Nurse Practitioner 5890022263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Charleston Counseling Center PCGroup PAC ID 6204125107, 186 clinicians

Practice addresses (Care Compare)

2000 Ctr Point Rd
Suite 2350
Columbia, SC 29210-5826
Phone (843) 501-1099

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Counseling Center PC CurrentSince Apr 1, 2024 Accepting new patients
Myrtle Beach Counseling Center PastSince Aug 6, 2019 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

2000 Center Point Rd
Ste 2350
Columbia, SC 29210
Phone (803) 338-3739

871 Lowcountry Blvd
Ste 200
Mt Pleasant, SC 29464
Phone (253) 346-0137

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.kimberlyhammonds@149035.advancedmd-direct.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1093376832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 514",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648500514",
            "telephone_number": "417-592-1667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 CENTER POINT DRIVE",
            "address_2": "SUITE 2350",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 E 32nd St",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "648043312",
            "country_code": "US",
            "telephone_number": "417-347-7567",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "530 E 34th St",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "648043926",
            "country_code": "US",
            "telephone_number": "417-347-7630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMMONDS",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "DNP, RN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "27642",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2019022617",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.