Kimberley S Ennis, ANP

Primary specialty

Chore ProviderTaxonomy code 372500000X

License

F304768-1 Issued in NY

Practice address

1 Gustave L Levy PL
New York, NY 10029-6500

Phone

(212) 241-5544

NPI assigned

Mar 21, 2008

Last updated

Jul 10, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1206057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310256000000",
    "number": "1275704819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 E 34TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112033801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296500",
            "telephone_number": "212-241-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "KIMBERLEY",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-21",
        "last_updated": "2011-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": "NY",
            "license": "F304768-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derek Enlander, MD
• William Enlow, CRNA
• Christina Ennabi Waller, DO
• Frederick C. Ennette
• Ciara Ennis, AGACNP-BC
• Rebecca Ennis, SLP-CCC
• Ronald D Ennis, MD
• Walettra Charmese Enoch, NP
• Marisa Enrico
• Amber Enright, PA-C

• Chore Provider in New York, NY
• Providers in New York, NY by specialty
• Chore Provider in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.