Kimberly Lynn Cantu, NURSE PRACTITIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

300614 Issued in AZ

Practice address

4921 E Bell Rd Ste 205
Scottsdale, AZ 85254-6002

Phone

(800) 640-3451

NPI assigned

May 23, 2008

Last updated

Nov 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM, AZ, OR3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Corner Health Medical Group P aGroup PAC ID 5799223236, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kcantu11446@ahs.direct-ci.com

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.

• Corner Health Medical Group P a

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1205689171
  Medicare reassignment Care Compare group NPD
• Southwest Medical Associates, LLC

  dba Lovelace Medical Group

  • General Practice Physician
  • Albuquerque, NM
  • NPI 1164491072
  Medicare reassignment NPD
• Spencer J Hardenbrook MD PC

  • Family Medicine Physician
  • Draper, UT
  • NPI 1073909594

  AZ, NM

  Medicare reassignment NPD
• Sante Et Beaute Med Spa LLC

  dba Sante et Beaute Wellness and Primary Care

  • Adult Health Nurse Practitioner
  • Tucson, AZ
  • NPI 1447166921
  NPD (past) Authorized official
• Family Medicine PC

  • Family Medicine Physician
  • Albuquerque, NM
  • NPI 1083802029
  NPD
• Southwest Medical Associates, LLC

  • Rural Health Clinic/Center
  • Roswell, NM
  • NPI 1578255253
  NPD
• Critical Care Services, P.C.

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1942256250
  NPD (past)

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

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1205094463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1200",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840621200",
            "telephone_number": "800-640-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 E BELL RD STE 205",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852546002",
            "telephone_number": "800-640-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTU",
        "first_name": "KIMBERLY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-23",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "300614",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "145260",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith J Cannon, M.D.
• Sandra Cannon
• Scott A. Cannon, M.D.
• Ramona Cano, MS
• Benjamin Nels Cantrill, DO
• Kevin Patrick Cantwell, PA-C
• Reina Marissa Canute
• Canyon Medical
• Canyon State Anesthesiologists PC
• Jiamin Cao

• Nurse Practitioner in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.