Kimberley Roberts, RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

041491402 Issued in IL

Practice address

108 W Market St
Bloomington, IL 61701-3918

Phone

(309) 827-5351

NPI assigned

May 13, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

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 and National Provider Directory roles.

• McLean County Center for Human Services, Inc

  • Community/Behavioral Health Agency
  • Bloomington, IL
  • NPI 1245233493
  NPD (past)

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

{
    "created_epoch": "1336867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1346509288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 W MARKET ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013918",
            "telephone_number": "309-827-5351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 W MARKET ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013918",
            "telephone_number": "309-827-5351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 Wood St",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955014413",
            "country_code": "US",
            "telephone_number": "707-268-2990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KIMBERLEY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-13",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "IL",
            "license": "041491402",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "808374",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Hermann DC SC
• Robert S. Baller, MD,PC
• Clarissa Renee Robert, MS, CCC-SLP
• Bethany Roberts
• Jeanette Lois Roberts, L.C.S.W.
• Ned (Bud) Owen Roberts, D.MIN.
• Paula Roberts, ANP, FNP-C
• Camden J Robinson
• Crystal C Robinson
• Linda Darlene Robinson, MSW

• Psychiatric/Mental Health Registered Nurse in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Psychiatric/Mental Health Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; 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.