NPIMap

Individual provider Active NPI

Kimberly Anne Mitchell, FNP

  • Family Nurse Practitioner
  • Paris, MO
National Provider Identifier
1124790878
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2021039897 Issued in MO
Practice address
102 E Marion St
Paris, MO 65275-1041
Phone
(660) 327-4911
Fax
(660) 327-5501
NPI assigned
Oct 1, 2021
Last updated
Apr 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2021039897 MO Primary

Addresses

Primary practice location

102 E Marion St
Paris, MO 65275-1041

Mailing address

102 E Marion St
Paris, MO 65275-1041
Phone (660) 327-4911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220104002430 MO Practitioner - Nurse Practitioner 5890186605 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

102 E Marion St
Paris, MO 65275-1041
Phone (660) 327-4911

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021039897MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hannibal Regional Healthcare System Inc CurrentSince Apr 1, 2024 Accepting new patients
Hannibal Regional Healthcare System, Inc Current Accepting new patients
Blessing Corporate Services, Inc Current Accepting new patients
Blessing Corporate Services, Inc CurrentSince Oct 12, 2021 Accepting new patients
Hannibal Regional Healthcare System, Inc CurrentSince Apr 1, 2024 Accepting new patients
Blessing Corporate Services Inc Family Current Accepting new patients
Blessing Corporate Services Inc CurrentSince Oct 12, 2021 Accepting new patients
Hannibal Regional Healthcare System, Inc Past Accepting new patients

Locations

1005 Broadway St
Quincy, IL 62301

6500 Hospital Dr
Hannibal, MO 63401
Phone (573) 629-3400

103 E Commercial St
Kahoka, MO 63445
Phone (660) 727-3377

6996 County Road 326
Palmyra, MO 63461
Phone (573) 769-3710

102 E Marion St
Paris, MO 65275
Phone (660) 327-4911

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602
  • Direct secure messaging: kimberly.mitchell.p1@direct.cfmkv.nextgenshare.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 10

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": "1633046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1124790878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 E MARION ST",
            "city": "PARIS",
            "state": "MO",
            "postal_code": "652751041",
            "telephone_number": "660-327-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E MARION ST",
            "city": "PARIS",
            "state": "MO",
            "postal_code": "652751041",
            "telephone_number": "660-327-4911",
            "fax_number": "660-327-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-01",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2021039897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paris, MO

Sources for this page

Verify at the official NPI Registry.