Individual provider Active NPI

Kimberly Dozier-Thornton, MD

  • Pediatrics Physician
  • Cocoa Beach, FL
National Provider Identifier
1275827685
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME118378 Issued in FL
Practice address
699 W Cocoa Beach Cswy Ste 401
Cocoa Beach, FL 32931-3562
Phone
(321) 784-5437
NPI assigned
Jun 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME118378 FL Primary

Addresses

Primary practice location

699 W Cocoa Beach Cswy Ste 401
Cocoa Beach, FL 32931-3562

Mailing address

134 S Woods Dr
Rockledge, FL 32955-3262
Phone (321) 636-3066

Other practice location 1

134 S Woods Dr
Rockledge, FL 32955-3262
Phone (321) 636-3066

Other identifiers 1

IdentifierTypeStateIssuer
011059000MedicaidFL

Other names 1

  • Kimberly Dozier Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130314000367 FL Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 3678718913

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Florida, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kimberly.dozier-thornton.1@8042.direct.athenahealth.com

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": "1306972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1275827685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 S WOODS DR",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553262",
            "telephone_number": "321-636-3066",
            "fax_number": "321-636-2545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 W COCOA BEACH CSWY STE 401",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329313562",
            "telephone_number": "321-784-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "134 S Woods Dr",
            "address_purpose": "LOCATION",
            "city": "Rockledge",
            "state": "FL",
            "postal_code": "329553262",
            "country_code": "US",
            "telephone_number": "321-636-3066",
            "fax_number": "321-636-2545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOZIER-THORNTON",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-02",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME118378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011059000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "DOZIER",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cocoa Beach, FL

Sources for this page

Verify at the official NPI Registry.