Individual provider Active NPI

Kimberly Deniese McDaniel, AUTONOMOUS APRN

  • Nurse Practitioner
  • Merritt Island, FL
National Provider Identifier
1114403482
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9250594 Issued in FL
Practice address
775 E Merritt Island Cswy Ste 115
Merritt Island, FL 32952-3311
Phone
(321) 349-0642
Fax
(321) 349-0643
NPI assigned
Jul 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 9250594 FL Primary

Addresses

Primary practice location

775 E Merritt Island Cswy Ste 115
Merritt Island, FL 32952-3311

Mailing address

680 Venetian Way
Merritt Island, FL 32953-4116
Phone (321) 609-0654

Other practice location 1

680 Venetian Way
Merritt Island, FL 32953-4116
Phone (321) 609-0654

Other names 1

  • Kimberly Deniese Lemay Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240206002445 FL Practitioner - Nurse Practitioner 0840642161 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
Hand in Hand Healthcare PLLCGroup PAC ID 7113379439, 2 clinicians

Practice addresses (Care Compare)

775 E Merritt Island Cswy
Suite 115
Merritt Island, FL 32952-3311
Phone (321) 349-0642

Hospital & facility affiliations

  • Cape Canaveral Hospital Hospital, Cocoa Beach, FL, CCN 100177
  • Parrish Medical Center Hospital, Titusville, FL, CCN 100028
  • Viera Hospital Hospital, Melbourne, FL, CCN 100315

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9250594FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hand in Hand Healthcare PLLC CurrentSince Jan 2, 2024 Accepting new patients

Locations

775 E Merritt Island Cswy
Ste 115
Merritt Island, FL 32952
Phone (321) 349-0642

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ADIFDD/Endpoint/ADIFDD

Organizations & group practices 1

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 & facility affiliations 3

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": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1114403482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 VENETIAN WAY",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329534116",
            "telephone_number": "321-609-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 E MERRITT ISLAND CSWY STE 115",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329523311",
            "telephone_number": "321-349-0642",
            "fax_number": "321-349-0643"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 Venetian Way",
            "address_purpose": "LOCATION",
            "city": "Merritt Island",
            "state": "FL",
            "postal_code": "329534116",
            "country_code": "US",
            "telephone_number": "321-609-0654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "KIMBERLY",
        "middle_name": "DENIESE",
        "name_prefix": "Mrs.",
        "credential": "AUTONOMOUS APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-19",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "9250594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "LEMAY",
            "middle_name": "DENIESE",
            "credential": "AUTONOMOUS APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Merritt Island, FL

Sources for this page

Verify at the official NPI Registry.