Kimberly Rae Warren, MSN, APRN, AGPCNP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

RN269449 Issued in GA

Practice address

2203 Ga Highway 130 W
Vidalia, GA 30474-5555

Phone

(912) 245-5491

NPI assigned

Jul 14, 2023

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

Enrolled in GA

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospital Authority of Candler CountyGroup PAC ID 5294623948, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Candler County Hospital Hospital, Metter, GA, CCN 111334

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Hospital Authority of Candler County

  • Medicare Defined Swing Bed Hospital Unit
  • Metter, GA
  • NPI 1588868947
  Medicare reassignment Care Compare group NPD
• Dr. F. Geoffery Conner PC

  • Internal Medicine Physician
  • Vidalia, GA
  • NPI 1376729228
  Medicare reassignment
• Hospital Authority of Candler County

  • Primary Care Clinic/Center
  • Pulaski, GA
  • NPI 1316523707
  NPD
• Hospital Authority of Candler County

  • Critical Access Hospital
  • Metter, GA
  • NPI 1790888089
  NPD
• Hospital Authority of Candler County

  • Rural Health Clinic/Center
  • Metter, GA
  • NPI 1790088169
  NPD (past)
• Hospital Authority of Candler County

  • Rural Health Clinic/Center
  • Metter, GA
  • NPI 1831728005
  NPD (past)

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

• Hospital Authority of Candler County

  • Critical Access Hospital
  • Metter, GA
  • NPI 1790888089
  Care Compare affiliation

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

{
    "created_epoch": "1689292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1104505460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2203 GA HIGHWAY 130 W",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304745555",
            "telephone_number": "912-245-5491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2203 GA HIGHWAY 130 W",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304745555",
            "telephone_number": "912-245-5491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "KIMBERLY",
        "middle_name": "RAE",
        "credential": "MSN, APRN, AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-14",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN269449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly White Wall, FNP-C
• Elizabeth Denise Wallace
• Leah M Waller, PA
• Deborah Ward, L.P.C.
• Carl Anthony Wardlaw, LPC
• Weber Therapy Associates, Inc.
• Wheeler County Family Medicine
• Oliver Cleveland Whipple, R.PH.
• Zachary Jordan Whitaker, PA
• White Medical Services, PC

• Adult Health Nurse Practitioner in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Adult Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.