Individual provider Active NPI

Kimberley Dalton Chitko, ARNP

  • Family Nurse Practitioner
  • Bedford, TX
National Provider Identifier
1164559589
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP117670 Issued in TX
Practice address
1604 Hospital Pkwy Ste 200
Bedford, TX 76022
Phone
(817) 848-4485
Fax
(817) 848-4490
NPI assigned
Feb 27, 2007
Last updated
Aug 28, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 9232299 FL
Family Nurse Practitioner 363LF0000X 0024170572 VA
Family Nurse Practitioner 363LF0000X R156907 MD
Family Nurse Practitioner 363LF0000X AP117670 TX Primary

Addresses

Primary practice location

1604 Hospital Pkwy Ste 200
Bedford, TX 76022

Mailing address

1604 Hospital Pkwy Ste 200
Bedford, TX 76022-6930
Phone (817) 848-4485

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20130409000114 VA Practitioner - Nurse Practitioner 7214053420 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9232299FLMDNurse Practitioner
R156907MDMDFamily Nurse Practitioner
AP117670TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neurologic Associates PLC CurrentSince Oct 8, 2023 Accepting new patients

Locations

905 Cedar Creek Grade
Ste 200
Winchester, VA 22601
Phone (540) 722-8882

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1164559589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 HOSPITAL PKWY STE 200",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760226930",
            "telephone_number": "817-848-4485",
            "fax_number": "817-848-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 HOSPITAL PKWY STE 200",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "76022",
            "telephone_number": "817-848-4485",
            "fax_number": "817-848-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHITKO",
        "first_name": "KIMBERLEY",
        "middle_name": "DALTON",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "9232299",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024170572",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R156907",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP117670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, TX

Sources for this page

Verify at the official NPI Registry.