Individual provider Active NPI

Kimberly Childs, RN

  • Registered Nurse
  • Columbus, OH
National Provider Identifier
1265286280
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN519421 Issued in OH
Practice address
1585 Neil Ave
Columbus, OH 43210-1216
Phone
(614) 563-2054
NPI assigned
Apr 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN519421 OH Primary

Addresses

Primary practice location

1585 Neil Ave
Columbus, OH 43210-1216

Mailing address

1585 Neil Ave
Columbus, OH 43210-1216
Phone (614) 292-4041

Other names 1

  • Kimberly Childs Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250711000543 NY Practitioner - Nurse Practitioner 8224543152 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN519421OHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Medical PC CurrentSince Jun 15, 2025 Accepting new patients
North Medical PC Current Accepting new patients

Locations

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

Organizations & group practices 2

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": "1713225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1265286280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1585 NEIL AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101216",
            "telephone_number": "614-292-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 NEIL AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101216",
            "telephone_number": "614-563-2054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDS",
        "first_name": "KIMBERLY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-16",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN519421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "CHILDS",
            "credential": "RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.