Active NPI
Kimberly Dianne Callender, FNP-BC
- Family Nurse Practitioner
- New York, NY
National Provider Identifier
1144661760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 337940
- Practice address
- 30 Broad St FL 45
New York, NY 10004-2942 - Phone
- (212) 530-0630
- NPI assigned
- Jul 11, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN1043735 | DC | |
| Family Nurse Practitioner | 363LF0000X | R226670 | MD | |
| Family Nurse Practitioner | 363LF0000X | 337940 | NY | Primary |
Addresses
Primary practice location
30 Broad St FL 45
New York, NY 10004-2942
Mailing address
1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791
Other practice location 1
632 Broadway Ph
New York, NY 10012-2614
Phone (800) 731-4254
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medstar Urgent Care LLC | Current | Accepting new patients | |
| Saint Francis Medical Center | Past | Accepting new patients | |
| Cloud Health Medical Group, P.a. | Past | Accepting new patients | |
| Openloop Healthcare Partners California PC | Past | Accepting new patients |
Locations
6317 York Rd
Baltimore, MD 21212
Phone (443) 777-6890
3064 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 932-5960
Interoperability endpoints
- kcallender1540099@direct.trinity-health.org
- kimberly.callender.1@19957.direct.athenahealth.com
Organizations & group practices 4
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.
-
- Urgent Care Clinic/Center
- Baltimore, MD
- NPI 1902175870
-
- Internal Medicine Physician
- White Plains, NY
- NPI 1528744935
-
- General Practice Physician
- Palm Desert, CA
- NPI 1659042331
-
- Internal Medicine Physician
- Cape Girardeau, MO
- NPI 1578513016
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664236800000",
"number": "1144661760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 EMBARCADERO CTR STE 1900",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941113723",
"telephone_number": "415-658-6791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 BROAD ST FL 45",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100042942",
"telephone_number": "212-530-0630"
}
],
"practiceLocations": [
{
"address_1": "632 Broadway Ph",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100122614",
"country_code": "US",
"telephone_number": "800-731-4254",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CALLENDER",
"first_name": "KIMBERLY",
"middle_name": "DIANNE",
"name_prefix": "Ms.",
"credential": "FNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-11",
"last_updated": "2022-09-27",
"certification_date": "2022-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "DC",
"license": "RN1043735",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MD",
"license": "R226670",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "337940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.