Individual provider Active NPI

Kimberly Kristin Cummings, FNP-C

  • Family Nurse Practitioner
  • Roanoke, AL
National Provider Identifier
1104472208
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-149155 Issued in AL
Practice address
1950 Main St
Roanoke, AL 36274-2512
Phone
(334) 863-2311
NPI assigned
Aug 14, 2019
Last updated
Sep 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 1-149155 AL
Family Nurse Practitioner 363LF0000X 1-149155 AL Primary

Addresses

Primary practice location

1950 Main St
Roanoke, AL 36274-2512

Mailing address

PO Box 2345
Anniston, AL 36202-2345
Phone (334) 863-1249

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20191112002053 AL Practitioner - Nurse Practitioner 0042642100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1950 Main St
Roanoke, AL 36274-2512
Phone (334) 863-2311

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-149155ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Health Management Corporation CurrentSince Sep 1, 2019 Accepting new patients
Regional Health Management Corporation CurrentSince Sep 1, 2019 Accepting new patients

Locations

901 Leighton Ave
Ste 204
Anniston, AL 36207
Phone (256) 235-5015

1950 Main St
Roanoke, AL 36274
Phone (256) 236-4121

Interoperability endpoints

  • Direct secure messaging: kimberly.cummings.1@15682.direct.athenahealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1104472208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2345",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362022345",
            "telephone_number": "334-863-1249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 MAIN ST",
            "city": "ROANOKE",
            "state": "AL",
            "postal_code": "362742512",
            "telephone_number": "334-863-2311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUMMINGS",
        "first_name": "KIMBERLY",
        "middle_name": "KRISTIN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-14",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AL",
            "license": "1-149155",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-149155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, AL

Sources for this page

Verify at the official NPI Registry.