Individual provider Active NPI

Kimberly Dawn Nolte, NP

  • Family Nurse Practitioner
  • Fairhope, AL
National Provider Identifier
1184809691
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-072405 Issued in AL
Practice address
150 S Ingleside St Ste 6
Fairhope, AL 36532-1804
Phone
(251) 990-1740
Fax
(251) 990-1831
NPI assigned
Jan 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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 1-072405 AL Primary

Addresses

Primary practice location

150 S Ingleside St Ste 6
Fairhope, AL 36532-1804

Mailing address

188 Hospital Dr
Ste 402
Fairhope, AL 36532-2043
Phone (251) 990-1740

Other identifiers 2

IdentifierTypeStateIssuer
145466MedicaidAL
51131838OtherALBCBS

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080416000055 AL Practitioner - Nurse Practitioner 4688750714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairhope Internal Medicine PC 9 clinicians

Practice addresses (Care Compare)

6 Medical Park
Fairhope, AL 36532-1804
Phone (251) 990-1740

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Daphne, AL, CCN 017058
  • Thomas Hospital Hospital, Fairhope, AL, CCN 010100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairhope Internal Medicine PC CurrentSince Dec 1, 2012 Accepting new patients
Sacred Heart Health System, Inc. Past Accepting new patients
Medical Park OBGYN PC PastSince Aug 1, 2009 Accepting new patients
Foley Emergency Physicians, LLC PastSince Jan 26, 2020 Accepting new patients
Checkups - Al LLC Past Accepting new patients

Locations

6 Medical Park Dr
Fairhope, AL 36532
Phone (251) 272-1192

750 Morphy Ave
Fairhope, AL 36532
Phone (251) 928-2375

188 Hospital Dr
Ste 402
Fairhope, AL 36532
Phone (251) 279-1245

150 S Ingleside St
#6
Fairhope, AL 36532
Phone (251) 928-1222

6 Medical Park
Fairhope, AL 36532
Phone (251) 990-1740

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: knolte24189@directinfirmaryhealth.org

Organizations & group practices 5

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": "1199232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1184809691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 HOSPITAL DR",
            "address_2": "STE 402",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365322043",
            "telephone_number": "251-990-1740",
            "fax_number": "251-990-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S INGLESIDE ST STE 6",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365321804",
            "telephone_number": "251-990-1740",
            "fax_number": "251-990-1831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLTE",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-02",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-072405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145466",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51131838",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhope, AL

Sources for this page

Verify at the official NPI Registry.