Kimberly Ann Kemnitzer, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2004019274 Issued in MO

Practice address

216 W 3Rd St
Salem, MO 65560-1336

Phone

(573) 453-5070

Fax

(573) 340-6086

NPI assigned

Feb 5, 2008

Last updated

Jun 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Kimberly Ann Grauf Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 1, 2023 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)
• Texas County Memorial Hospital

  dba TCMH Internal Medicine

  • Rural Health Clinic/Center
  • Houston, MO
  • NPI 1710004486
  NPD (past)

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1336327055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 W 3RD ST",
            "city": "SALEM",
            "state": "MO",
            "postal_code": "655601336",
            "telephone_number": "573-453-5070",
            "fax_number": "573-340-6086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 W 3RD ST",
            "city": "SALEM",
            "state": "MO",
            "postal_code": "655601336",
            "telephone_number": "573-453-5070",
            "fax_number": "573-340-6086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMNITZER",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-05",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2004019274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447412770",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "26D0679044",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306885587",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2004019274",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235178930",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710004486",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "26D0889777",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "GRAUF",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kimberely L Ingram, LPC
• Andrea Elizabeth Jadwin, PHARM D
• Kaylie Jay
• David Bruce Johnson, DDS
• Bradley D. Jones, D.O.
• Key Rehabilitation,Inc. (GeroPsych, a division of Key Rehabilitation, Inc.)
• Erum Khan, M.D.
• Kailie Kinder, SLP-A
• Rose F Kinerk, MW
• Jonathan Kinney, LPC

• Family Nurse Practitioner in Salem, MO
• Providers in Salem, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.