Active NPI
Kimberly Ann Greenwalt, LPN
- Licensed Practical Nurse
- Flora, IL
National Provider Identifier
1164523221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- Practice address
- 201 E N Ave
Clay Medical Center
Flora, IL 62839 - Phone
- (618) 662-8386
- Fax
- (618) 662-4338
- NPI assigned
- Sep 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | IL | Primary |
Addresses
Primary practice location
201 E N Ave
Clay Medical Center
Flora, IL 62839
Mailing address
PO Box 155
Rea Clinic
Christopher, IL 62822
Phone (618) 724-2401
Other names 1
- Mrs. Kimberly Ann Karr
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 043080308 | IL | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164523221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 155",
"address_2": "REA CLINIC",
"city": "CHRISTOPHER",
"state": "IL",
"postal_code": "62822",
"telephone_number": "618-724-2401",
"fax_number": "618-724-2571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 E N AVE",
"address_2": "CLAY MEDICAL CENTER",
"city": "FLORA",
"state": "IL",
"postal_code": "62839",
"telephone_number": "618-662-8386",
"fax_number": "618-662-4338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENWALT",
"first_name": "KIMBERLY",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KIMBERLY",
"last_name": "KARR",
"middle_name": "ANN",
"prefix": "MRS.",
"credential": "LPN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Flora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.