Sophia Kibuismith

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

6907085 Issued in FL

Practice address

4811 5TH Ave S
St Petersburg, FL 33711-1421

Phone

(425) 246-5077

NPI assigned

Oct 23, 2023

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1346012572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4811 5TH AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337111421",
            "telephone_number": "425-246-5077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4811 5TH AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337111421",
            "telephone_number": "425-246-5077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIBUISMITH",
        "first_name": "SOPHIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": "6907085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hani J. Khella, M.D.
• Linda Khmelnytska
• Katherine Lisa Khokhar, CRNA
• Debbie Kiag, P.T.
• Steven Mariano Kiag, P.T.
• June Kicklighter Peterman
• Kidney Life, Inc.
• Kids Home Care, Inc.
• Anna Deelynn Kidwell, RN
• Emma Kidwell

• Adult Care Home Facility in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Adult Care Home Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.