Individual provider Active NPI

Kimberly Alain Cook, FNP-BC

  • Family Nurse Practitioner
  • Roanoke, VA
National Provider Identifier
1205465101
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024178482 Issued in VA
Practice address
1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone
(540) 981-7269
NPI assigned
Apr 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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 0024178482 VA Primary

Addresses

Primary practice location

1906 Belleview Ave SE
Roanoke, VA 24014-1838

Mailing address

213 S Jefferson St Ste 625
Roanoke, VA 24011-1713
Phone (540) 224-5679

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kcook127751@direct.carilionclinic.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20200630003289 VA Practitioner - Nurse Practitioner 3971926494 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024178482VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Healthcare Corporation CurrentSince Aug 19, 2025 Accepting new patients
Carilion Medical Center CurrentSince Jul 20, 2020 Accepting new patients
Carilion Healthcare Corporation CurrentSince Aug 19, 2025 Accepting new patients
Carilion Medical Center CurrentSince Jul 20, 2020 Accepting new patients

Locations

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

213 S Jefferson St
Ste 625
Roanoke, VA 24011
Phone (540) 224-5677

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110

Interoperability endpoints

  • Direct secure messaging: kcook127751@direct.carilionclinic.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": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1205465101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 625",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713",
            "telephone_number": "540-224-5679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 BELLEVIEW AVE SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141838",
            "telephone_number": "540-981-7269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "KIMBERLY",
        "middle_name": "ALAIN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024178482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcook127751@direct.carilionclinic.org",
            "affiliation": "N",
            "endpointDescription": "kcook127751@direct.carilionclinic.org",
            "address_1": "1906 Belleview Ave SE",
            "city": "Roanoke",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240141838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.