Individual provider Active NPI

Kimberly Gastenveld

  • Family Nurse Practitioner
  • Covington, KY
National Provider Identifier
1184168247
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3010950 Issued in KY
Practice address
1401 Madison Ave
Covington, KY 41011-3313
Phone
(859) 655-6100
Fax
(859) 655-6148
NPI assigned
Dec 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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 3010950 KY Primary

Addresses

Primary practice location

1401 Madison Ave
Covington, KY 41011-3313

Mailing address

215 E 11TH St
Newport, KY 41071-2203
Phone (859) 655-6100

Other practice location 1

7607 Dixie Hwy
Florence, KY 41042-2644
Phone (859) 655-6100

Other identifiers 1

IdentifierTypeStateIssuer
3010950OtherKYKY LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20221206000133 OH Practitioner - Nurse Practitioner 6103108824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3188 Bellevue Ave
Cincinnati, OH 45219-2369
Phone (513) 584-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
65.97
Promoting interoperability
100
Improvement activities
40
Cost
74.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3010950KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Cincinnati Physicians Company, LLC CurrentSince Nov 21, 2022 Accepting new patients

Locations

3200 Burnet Ave
#2
Cincinnati, OH 45229
Phone (513) 585-5505

3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281

2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523

3151 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 584-3494

7700 University Dr
West Chester, OH 45069
Phone (513) 298-3000

7675 Wellness Way
Ste 201
West Chester, OH 45069
Phone (513) 475-7439

7675 Wellness Way
West Chester, OH 45069
Phone (513) 475-7400

Organizations & group practices 1

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 2

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": "1481155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1184168247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E 11TH ST",
            "city": "NEWPORT",
            "state": "KY",
            "postal_code": "410712203",
            "telephone_number": "859-655-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MADISON AVE",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410113313",
            "telephone_number": "859-655-6100",
            "fax_number": "859-655-6148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7607 Dixie Hwy",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "KY",
            "postal_code": "410422644",
            "country_code": "US",
            "telephone_number": "859-655-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GASTENVELD",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-08",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3010950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY LICENSE",
            "identifier": "3010950",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, KY

Sources for this page

Verify at the official NPI Registry.