Individual provider Active NPI

Kimberly Dawn Knoerlein

  • Neonatal Nurse Practitioner
  • Lebanon, NH
National Provider Identifier
1144320904
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
041319-23-10 Issued in NH
Practice address
1 Medical Center Dr
Lebanon, NH 03756-0001
Phone
(603) 650-5000
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 041319-23 NH
Neonatal Nurse Practitioner 363LN0000X 041319-23-10 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
Lebanon, NH 03756-0001

Mailing address

1 Medical Center Dr
Lebanon, NH 03756-1000
Phone (603) 650-7256

Other identifiers 2

IdentifierTypeStateIssuer
30340253MedicaidNH
0NP1652MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, VT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080218000139 NH Practitioner - Nurse Practitioner 3870676653 Reassigns benefits to 2 organizations
I20251023003360 VT Practitioner - Nurse Practitioner 3870676653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

17 Belmont Ave
Brattleboro, VT 05301-3498

PO Box
Suite 248
Bristol, NH 03222

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041319-23NHMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dartmouth-Hitchcock Clinic CurrentSince Jan 20, 2025 Accepting new patients
Mary Hitchcock Memorial Hospital Current Accepting new patients
Brattleboro Memorial Hospital CurrentSince Sep 12, 2025 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jan 20, 2025 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jan 20, 2025 Accepting new patients

Locations

789 Central Ave
Fl 3
Dover, NH 03820

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

17 Belmont Ave
Brattleboro, VT 05301
Phone (802) 257-8360

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/d9dc001d-1bc5-42f9-bd4d-eb79208fd32a/
  • Direct secure messaging: kknoerlein14095@direct.dartmouth-hitchcock.org

Organizations & group practices 5

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1144320904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-7256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001",
            "telephone_number": "603-650-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOERLEIN",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "NH",
            "license": "041319-23",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "NH",
            "license": "041319-23-10",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30340253",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0NP1652",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.