Kimberly Deshan Daniels, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A004782 Issued in AR

Practice address

1007 E Matthews Ave
Jonesboro, AR 72401-4308

Phone

(870) 336-0472

Fax

(870) 336-5320

NPI assigned

Jun 21, 2016

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 AR

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Bernards Physician Clinics IncGroup PAC ID 7012311269, 211 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Bernards Medical Center Hospital, Jonesboro, AR, CCN 040020
• St Bernards Five Rivers Medical Center Hospital, Pocahontas, AR, CCN 040779
• Crossridge Community Hospital Hospital, Wynne, AR, CCN 041307

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kdaniels@sbpc.medalliesdirect.net

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.

• St Bernards Physician Clinics Inc

  dba St Bernards Surgical Associates

  • Surgery Physician
  • Jonesboro, AR
  • NPI 1447923438
  Medicare reassignment Care Compare group NPD
• St Bernards Physician Clinics Inc

  • Diagnostic Radiology Physician
  • Jonesboro, AR
  • NPI 1780546051
  NPD
• St Bernards Physician Clinics, Inc.

  • Internal Medicine Physician
  • Jonesboro, AR
  • NPI 1407577216
  NPD

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

• Five Rivers Medical Center Inc.

  dba St. Bernards Five Rivers Medical Center

  • General Acute Care Hospital
  • Pocahontas, AR
  • NPI 1528360989
  Care Compare affiliation
• St Bernard Community Hospital Corporation

  • Critical Access Hospital
  • Wynne, AR
  • NPI 1962410183
  Care Compare affiliation
• St Bernards Hospital Inc

  dba St Bernards Medical Center

  • General Acute Care Hospital
  • Jonesboro, AR
  • NPI 1922043686
  Care Compare affiliation

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1184074197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CARSON ST",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013104",
            "telephone_number": "870-932-1198",
            "fax_number": "870-910-7715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 E MATTHEWS AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014308",
            "telephone_number": "870-336-0472",
            "fax_number": "870-336-5320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "KIMBERLY",
        "middle_name": "DESHAN",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A004782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dan Johnson PHD Clinical Neuropsychologist,P.a.
• Daniel & Max, LLC (Stanton Optical)
• Daniel Bennett MD PA (Jonesboro Clinic)
• David Daniel, MD
• Heather Daniels, MCD,CCC-SLP
• Rileigh Smith Daniels
• Danny E Grubbs (Jonesboro Internal Medicine Clinic)
• Marc Daou
• Jon D Dardenne, MHPP
• Bryan Charles Darling, D.D.S.,M.D.

• Family Nurse Practitioner in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; 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.