NPIMap

Individual provider Active NPI

Kimberly Dawn Jubb, FNP

  • Family Nurse Practitioner
  • Charlotte Court House, VA
National Provider Identifier
1174988950
Registry record updated Dec 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024173126 Issued in VA
Practice address
165 Legrande Ave.
Charlotte Court House, VA 23923
Phone
(434) 542-5560
NPI assigned
Dec 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024173126 VA Primary

Addresses

Primary practice location

165 Legrande Ave.
Charlotte Court House, VA 23923

Mailing address

PO Box 470
Charlotte Court House, VA 23923-0470
Phone (434) 542-5560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160404001583 VA Practitioner - Nurse Practitioner 3173820289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Virginia Health Services IncGroup PAC ID 0345158432, 94 clinicians

Practice addresses (Care Compare)

165 Legrande Ave
Charlotte Court House, VA 23923-3747
Phone (434) 542-5560

Hospital & facility affiliations

  • Centra Home Health Home health agency, Farmville, VA, CCN 497055
  • Southside Community Hospital, Inc Hospital, Farmville, VA, CCN 490090
  • Sentara Halifax Regional Hospital Hospital, South Boston, VA, CCN 490013
  • Centra Health - Lynchburg Gen Hospital Hospital, Lynchburg, VA, CCN 490021

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024173126VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Virginia Health Services Inc Current Accepting new patients
Central Virginia Health Services Inc CurrentSince Jan 16, 2016 Accepting new patients
Central Virginia Health Services Inc CurrentSince Jan 16, 2016 Accepting new patients
Central Virginia Health Services Inc Past Accepting new patients

Locations

25892 N James Madison Hwy
New Canton, VA 23123
Phone (434) 581-3271

Organizations & group practices 4

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.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1450742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450742400000",
    "number": "1174988950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 470",
            "city": "CHARLOTTE COURT HOUSE",
            "state": "VA",
            "postal_code": "239230470",
            "telephone_number": "434-542-5560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 LEGRANDE AVE.",
            "city": "CHARLOTTE COURT HOUSE",
            "state": "VA",
            "postal_code": "23923",
            "telephone_number": "434-542-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUBB",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-22",
        "last_updated": "2015-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024173126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte Court House, VA

Sources for this page

Verify at the official NPI Registry.