Individual provider Active NPI

Kimberly Villemarette Hull, FNP

  • Family Nurse Practitioner
  • Bossier City, LA
National Provider Identifier
1215426432
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP09850 Issued in LA
Practice address
5025 Shed Rd
Bossier City, LA 71111-5434
Phone
(318) 795-4741
Fax
(318) 795-4742
NPI assigned
May 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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 AP09850 LA Primary

Addresses

Primary practice location

5025 Shed Rd
Bossier City, LA 71111-5434

Mailing address

1959 Wild Iris
Bossier City, LA 71112-4681
Phone (318) 286-3786

Other practice location 1

1455 E Bert Kouns Industrial Loop Ste 300
Shreveport, LA 71105-6000
Phone (318) 798-4488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20181106002382 LA Practitioner - Nurse Practitioner 6103170303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highland Clinic, a Prof Med CorpGroup PAC ID 3870493463, 60 clinicians

Practice addresses (Care Compare)

5025 Shed Rd
Bossier City, LA 71111-5434
Phone (318) 795-4741

Hospital & facility affiliations

  • Christus Shreveport-Bossier Health System Hospital, Shreveport, LA, CCN 190041
  • Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP09850LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Clinic, a Prof Med Corp CurrentSince Jan 1, 2025 Accepting new patients
Highland Clinic, a Prof Med Corp CurrentSince Jan 1, 2025 Accepting new patients
Mary Bird Perkins Cancer Center PastSince Dec 4, 2019 Accepting new patients
Neurology & Sleep Clinic a Professional Medical Corp PastSince Jul 30, 2013 Accepting new patients
Highland Clinic Optical Shop, LLC Past Accepting new patients

Locations

5025 Shed Rd
Bossier City, LA 71111
Phone (318) 795-4741

1455 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 300-3643

1455 E Bert Kouns Industrial Loop
Ste 300
Shreveport, LA 71105
Phone (318) 798-4488

Interoperability endpoints

  • Direct secure messaging: kimberly.hull.p1@direct.hcapmc.nextgenshare.com

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1525219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1215426432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 WILD IRIS",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711124681",
            "telephone_number": "318-286-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5025 SHED RD",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711115434",
            "telephone_number": "318-795-4741",
            "fax_number": "318-795-4742"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1455 E Bert Kouns Industrial Loop Ste 300",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711056000",
            "country_code": "US",
            "telephone_number": "318-798-4488",
            "fax_number": "318-798-4672",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HULL",
        "first_name": "KIMBERLY",
        "middle_name": "VILLEMARETTE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-02",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP09850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bossier City, LA

Sources for this page

Verify at the official NPI Registry.