Individual provider Active NPI

Kimbra Ann Epps, FNP

  • Family Nurse Practitioner
  • Roseburg, OR
National Provider Identifier
1154406064
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
89000514N1 Issued in OR
Practice address
1959 NE Diamond Lake Blvd Ste 109
Roseburg, OR 97470-3573
Phone
(541) 492-1785
Fax
(833) 764-4112
NPI assigned
Oct 26, 2006
Last updated
Jan 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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 89000514N1 OR Primary

Addresses

Primary practice location

1959 NE Diamond Lake Blvd Ste 109
Roseburg, OR 97470-3573

Mailing address

1959 NE Diamond Lake Blvd Ste 109
Roseburg, OR 97470-3573
Phone (541) 492-1785

Other identifiers 1

IdentifierTypeStateIssuer
R103163OtherMEDICARE PART B

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20040416000795 OR Practitioner - Nurse Practitioner 1153316468 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1959 NE Diamond Lake Blvd
Suite 109
Roseburg, OR 97470-3501
Phone (541) 430-3444

1959 NE Diamond Lake Blvd
Suite 109
Roseburg, OR 97470-3573

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
89000514N1ORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Renew Womens Wellness Family PastSince Nov 18, 2025 Accepting new patients
Fred Luke Herscher Past Accepting new patients
Lifetime Health Clinic Past Accepting new patients

Organizations & group practices 3

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 1

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1154406064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 NE DIAMOND LAKE BLVD STE 109",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703573",
            "telephone_number": "541-492-1785",
            "fax_number": "833-764-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE DIAMOND LAKE BLVD STE 109",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703573",
            "telephone_number": "541-492-1785",
            "fax_number": "833-764-4112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPPS",
        "first_name": "KIMBRA",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "89000514N1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "R103163",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

Verify at the official NPI Registry.