Individual provider Active NPI

Kimberly Ann Bagley, AGPCNP-BC

  • Primary Care Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1194106989
Registry record updated Jun 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
228992 Issued in NC
Practice address
3400 Wake Forest Rd
Raleigh, NC 27609-7317
Phone
(919) 954-3000
NPI assigned
Jun 17, 2015
Last updated
Jun 17, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 228992 NC Primary

Addresses

Primary practice location

3400 Wake Forest Rd
Raleigh, NC 27609-7317

Mailing address

1519 Woodcroft Dr
Raleigh, NC 27609-3569
Phone (919) 607-6305

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
I20150901001341 NC Practitioner - Nurse Practitioner 4880900141 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke Health Integrated Practice IncGroup PAC ID 8325412737, 3,140 clinicians

Practice addresses (Care Compare)

3400 Wake Forest Rd
Suite 310
Raleigh, NC 27609-7317
Phone (919) 620-4855

40 Duke Medicine Cir
Durham, NC 27710-4000
Phone (919) 684-8111

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Duke Health Integrated Practice, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Duke University Health System, Inc. Nurse Practitioner Current Accepting new patients
Duke University Health System, Inc. CurrentSince Jul 1, 2015 Accepting new patients
Duke University Health System, Inc. CurrentSince Jul 1, 2015 Accepting new patients

Locations

2100 Erwin Rd
Durham, NC 27705
Phone (919) 648-8111

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-1300

3400 Wake Forest Rd
Raleigh, NC 27609
Phone (919) 954-3100

Interoperability endpoints

  • Direct secure messaging: kbagley49484@direct.medicine.duke.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434499200000",
    "number": "1194106989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1519 WOODCROFT DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276093569",
            "telephone_number": "919-607-6305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 WAKE FOREST RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097317",
            "telephone_number": "919-954-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGLEY",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-17",
        "last_updated": "2015-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "228992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.