Individual provider Active NPI

Kim A Madden, RN

  • Registered Nurse
  • Santa Barbara, CA
National Provider Identifier
1174784219
Registry record updated May 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
375706 Issued in CA
Practice address
402 E Carrillo St Ste B
Santa Barbara, CA 93101-7468
Phone
(805) 963-1086
NPI assigned
Jun 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 375706 CA Primary

Addresses

Primary practice location

402 E Carrillo St Ste B
Santa Barbara, CA 93101-7468

Mailing address

402 E Carrillo St Ste B
Santa Barbara, CA 93101-7468
Phone (805) 963-1086

Other identifiers 1

IdentifierTypeStateIssuer
375706OtherCAREGISTERED NURSE

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
375706CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305763200000",
    "number": "1174784219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 E CARRILLO ST STE B",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931017468",
            "telephone_number": "805-963-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 E CARRILLO ST STE B",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931017468",
            "telephone_number": "805-963-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDEN",
        "first_name": "KIM",
        "middle_name": "A",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-20",
        "last_updated": "2011-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "375706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "375706",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.