Kimberly C Boackle, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-072947 Issued in AL

Practice address

1509 6TH Ave S
Birmingham, AL 35233-1601

Phone

(205) 930-3204

Fax

(205) 930-3433

NPI assigned

Sep 12, 2014

Last updated

Jun 26, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cooper Green Mercy Health Services Authority an Affiliate of UabGroup PAC ID 0840629473, 95 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Cooper Green Mercy Health Services Authority an Affiliate of Uab

  • Clinic/Center
  • Birmingham, AL
  • NPI 1366073108
  Medicare reassignment Care Compare group NPD
• Cooper Green Mercy Health Services Authority an Affiliate of Uab

  dba Cooper Green Clinic Pharmacy

  • Clinic Pharmacy
  • Birmingham, AL
  • NPI 1568081644
  NPD
• Jefferson County Commission

  dba Cooper Green Health

  • Emergency Medicine Physician
  • Birmingham, AL
  • NPI 1225283518
  NPD (past)

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

{
    "created_epoch": "1410480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1174924880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2147 RIVERCHASE OFFICE RD",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352441836",
            "telephone_number": "205-421-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 6TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331601",
            "telephone_number": "205-930-3204",
            "fax_number": "205-930-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOACKLE",
        "first_name": "KIMBERLY",
        "middle_name": "C",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-12",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-072947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Felicity Neicole Blunt, MA, LPC
• Isabella Blutcher, RBT
• James Clifton Blutcher
• BMX Health LLC (LUX Infusion Centers 1)
• Charles C Boackle, MD
• Tomie Ann Boackle, PHARM.D.
• Daniel Riley Boalch
• Taylor Boatwright, PA-C
• Brenda Joyce Bobbitt, MSPCCCSLP
• Daniel Craig Bobbitt

• Family Nurse Practitioner in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; 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.