Individual provider Active NPI

Kristi Kimbler, NP

  • Acute Care Nurse Practitioner
  • Newnan, GA
National Provider Identifier
1164081303
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN183846 Issued in GA
Practice address
2326 Highway 34 E Ste 201
Newnan, GA 30265-1328
Phone
(678) 664-1545
NPI assigned
Jun 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN183846 GA Primary

Addresses

Primary practice location

2326 Highway 34 E Ste 201
Newnan, GA 30265-1328

Mailing address

2326 Highway 34 E
Ste 201
Newnan, GA 30265-1328
Phone (678) 664-1545

Other names 1

  • Kristi Nicole Johnson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20220124000256 GA Practitioner - Nurse Practitioner 3577955665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Georgia Renal and Hypertension Care IncGroup PAC ID 3678889425, 2 clinicians

Practice addresses (Care Compare)

2326 Hwy 34 E
Suite 201
Newnan, GA 30265-1328
Phone (678) 664-1545

Hospital & facility affiliations

  • Piedmont Newnan Hospital, Inc Hospital, Newnan, GA, CCN 110229
  • Piedmont Fayette Hospital Hospital, Fayetteville, GA, CCN 110215
  • Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN183846GAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Renal and Hypertension Care CurrentSince Dec 28, 2021 Accepting new patients

Locations

2326 Highway 34 E
Ste 201
Newnan, GA 30265
Phone (414) 736-5830

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": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1164081303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2326 HIGHWAY 34 E",
            "address_2": "STE 201",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302651328",
            "telephone_number": "678-664-1545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2326 HIGHWAY 34 E STE 201",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302651328",
            "telephone_number": "678-664-1545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBLER",
        "first_name": "KRISTI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-11",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN183846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTI",
            "last_name": "JOHNSON",
            "middle_name": "NICOLE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.