Kimberly Danielle, FNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2020038848 Issued in MO

Practice address

15450 S Outer 40 Rd Ste 100
Chesterfield, MO 63017-2062

Phone

(636) 489-1540

NPI assigned

Feb 27, 2019

Last updated

Jan 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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 MO

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Serenity Health LLC

  • Psychiatry Physician
  • Saint Peters, MO
  • NPI 1104569151
  Medicare reassignment NPD
• Palm Valley Health LLC

  • Multi-Specialty Clinic/Center
  • Chesterfield, MO
  • NPI 1023629458
  NPD Authorized official
• St. Louis Internal Medicine Inc

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1104856442
  NPD (past)

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

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1205393089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 NOONING TREE DR",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172468",
            "telephone_number": "314-800-6980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15450 S OUTER 40 RD STE 100",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172062",
            "telephone_number": "636-489-1540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "763 S New Ballas Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "63141",
            "country_code": "US",
            "telephone_number": "314-569-1717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANIELLE",
        "first_name": "KIMBERLY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-27",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2019006658",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2020038848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael William Daly, PHARM.D.
• Shannon Leigh Damm, OTR
• Dan W Charpentier DDS PC
• Bindu Jyothi Dandamudi, MD
• Sushma Dangi
• Janice Daniels, CRNA
• Abigail Rose Danielson, MOT
• Rand E Dankner, M.D.
• Frank Rocco Danna Jr., M.ED,NCC, LPC, LCSW.
• Ashley Danuser

• Psychiatric/Mental Health Nurse Practitioner in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.