Kimberly Michelle Gomez, MSN, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN206390 Issued in GA

Practice address

1601 Hwy 40 E
Ste M
Kingsland, GA 31548

Phone

(912) 409-0744

NPI assigned

Nov 20, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, FL2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Florida Jacksonville Physicians, Inc.Group PAC ID 9133025869, 908 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeast Georgia Health System -- Camden Campus Hospital, Saint Marys, GA, CCN 110146
• Shands Jacksonville Hospital, Jacksonville, FL, CCN 100001
• Southeast Georgia Health System- Brunswick Campus Hospital, Brunswick, GA, CCN 110025

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kgomez410114@direct.shands.ufl.edu

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.

• University of Florida Jacksonville Physicians, Inc.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1144276452

  GA

  Medicare reassignment Care Compare group NPD
• University of Florida Jacksonville Physicians Inc

  • Cardiovascular Disease Physician
  • Jacksonville, FL
  • NPI 1851551121
  NPD
• University of Florida Jacksonville Physicians, Inc.

  • Physiological Laboratory
  • Jacksonville, FL
  • NPI 1831800952
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Southeast Georgia Health System, Inc.

  • General Acute Care Hospital
  • Saint Marys, GA
  • NPI 1194744326
  Care Compare affiliation
• Southeast Georgia Health System, Inc.

  • General Acute Care Hospital
  • Brunswick, GA
  • NPI 1598784720
  Care Compare affiliation
• Shands Jacksonville Medical Center Inc

  • Urgent Care Clinic/Center
  • Jacksonville, FL
  • NPI 1144962408

  Hospital

  Care Compare affiliation
• Shands Jacksonville Medical Center Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1821186313
  Care Compare affiliation

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539907200000",
    "number": "1164936621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 SECOND ST S",
            "city": "FOLKSTON",
            "state": "GA",
            "postal_code": "315378447",
            "telephone_number": "912-496-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 HWY 40 E",
            "address_2": "STE M",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "31548",
            "telephone_number": "912-409-0744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Hwy 40 E",
            "address_2": "Ste M",
            "address_purpose": "LOCATION",
            "city": "Kingsland",
            "state": "GA",
            "postal_code": "31548",
            "country_code": "US",
            "telephone_number": "912-409-0744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "KIMBERLY",
        "middle_name": "MICHELLE",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-20",
        "last_updated": "2018-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9301655",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN206390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kimberly H Graw, APRN, BC, FNP
• Briana Gray
• Shilliane M Green
• Marissa Danielle Hagenbruch, DPT

• Family Nurse Practitioner in Kingsland, GA
• Providers in Kingsland, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.