Individual provider Active NPI

Kimberly Anne McCaffrey, APRN

  • Pediatric Nurse Practitioner
  • Sarasota, FL
National Provider Identifier
1225775745
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN11018055 Issued in FL
Practice address
2020 Cattlemen Rd Ste 600
Sarasota, FL 34232-6284
Phone
(941) 955-5191
NPI assigned
May 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APRN11018055 FL Primary

Addresses

Primary practice location

2020 Cattlemen Rd Ste 600
Sarasota, FL 34232-6284

Mailing address

2020 Cattlemen Rd
Sarasota, FL 34232-6243

Other practice location 1

2447 Sycamore St
North Port, FL 34289-9506
Phone (941) 955-5191

Other names 1

  • Kimberly Anne Boulds Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
APRN11018055FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Childcare Associates PastSince May 22, 2022 Accepting new patients

Organizations & group practices 1

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": "1652659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1225775745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 CATTLEMEN RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342326243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 CATTLEMEN RD STE 600",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342326284",
            "telephone_number": "941-955-5191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2447 Sycamore St",
            "address_purpose": "LOCATION",
            "city": "North Port",
            "state": "FL",
            "postal_code": "342899506",
            "country_code": "US",
            "telephone_number": "941-955-5191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCAFFREY",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-16",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN11018055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "BOULDS",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.