Individual provider Active NPI

Kimberly Neadow, NP

  • Family Nurse Practitioner
  • Cumming, GA
National Provider Identifier
1255733812
Registry record updated Oct 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
204418 Issued in GA
Practice address
101 Greenfield Dr Ste 100
Cumming, GA 30040-3171
Phone
(678) 845-7300
Fax
(678) 845-7301
NPI assigned
Sep 25, 2014
Last updated
Oct 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2025

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 204418 GA Primary

Addresses

Primary practice location

101 Greenfield Dr Ste 100
Cumming, GA 30040-3171

Mailing address

101 Greenfield Dr Ste 100
Cumming, GA 30040-3171
Phone (678) 845-7300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20160512001461 GA Order and Referring Only - Nurse Practitioner 8527357623

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
204418GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Infectious Disease Professionals, LLC Single Specialty CurrentSince Oct 21, 2025 Accepting new patients

Locations

101 Greenfield Dr
Ste 100
Cumming, GA 30040
Phone 6787861314103

1400 Northside Forsyth Dr
Ste 310
Cumming, GA 30041
Phone (678) 845-7300

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1411603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760745600000",
    "number": "1255733812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 GREENFIELD DR STE 100",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300403171",
            "telephone_number": "678-845-7300",
            "fax_number": "678-845-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 GREENFIELD DR STE 100",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300403171",
            "telephone_number": "678-845-7300",
            "fax_number": "678-845-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEADOW",
        "first_name": "KIMBERLY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-25",
        "last_updated": "2025-10-18",
        "certification_date": "2025-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "204418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.