Individual provider Active NPI

Kimberly Dawn Nail, NNP-BC

  • Critical Care Neonatal Nurse Practitioner
  • Chapel Hill, NC
National Provider Identifier
1194067892
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X
License
5006098 Issued in NC
Practice address
101 Manning Drive CB#7596 Room N4051
Chapel Hill, NC 27599-1231
Phone
(919) 966-5063
NPI assigned
Mar 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Neonatal Nurse Practitioner 363LN0005X 5006098 NC Primary

Addresses

Primary practice location

101 Manning Drive CB#7596 Room N4051
Chapel Hill, NC 27599-1231

Mailing address

2920 Highwoods Blvd
Raleigh, NC 27604-0010

Other practice location 1

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address knail123769@directHISP.wakemed.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20170329000533 NC Practitioner - Nurse Practitioner 0547545816 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5006098NCMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group, LLC CurrentSince Aug 22, 2019 Accepting new patients
Wakemed Specialists Group LLC CurrentSince Aug 22, 2019 Accepting new patients
Wakemed Specialists Group, LLC Current Accepting new patients
Park Ophthalmology Past Accepting new patients

Locations

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

2920 Highwoods Blvd
Raleigh, NC 27604

Interoperability endpoints

  • Direct secure messaging: knail20569@direct.unc.nchie.net
  • Direct secure messaging: knail123769@directhisp.wakemed.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1194067892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 HIGHWOODS BLVD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276040010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MANNING DRIVE CB#7596 ROOM N4051",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275991231",
            "telephone_number": "919-966-5063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 New Bern Ave",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276101231",
            "country_code": "US",
            "telephone_number": "919-350-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAIL",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "name_prefix": "Miss",
        "credential": "NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-20",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "NC",
            "license": "5006098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "knail123769@directHISP.wakemed.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "XML",
            "address_1": "3000 New Bern Ave",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276101231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.