Kimberley Sue Fahle

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

279734 Issued in AZ

Practice address

2675 N Wyatt Dr
Tucson, AZ 85712-6107

Phone

(937) 935-7461

NPI assigned

Dec 13, 2022

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

Enrolled in AZ

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.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Full Spectrum Wellness IncGroup PAC ID 6103359666, 2 clinicians

Grace Medical Group LLCGroup PAC ID 7012306624, 5 clinicians

Arizona Total Care LLCGroup PAC ID 6800128539, 18 clinicians

U2Rworthit1 LLCGroup PAC ID 8325435290, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tucson Medical Home Health Home health agency, Tucson, AZ, CCN 037498
• Bayada Home Health Care, Inc Home health agency, Tucson, AZ, CCN 037213
• St Joseph'S Hospital Hospital, Tucson, AZ, CCN 030011

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Arizona Total Care LLC

  • Multi-Specialty Clinic/Center
  • Tucson, AZ
  • NPI 1700433885
  Medicare reassignment Care Compare group NPD
• Bka PLLC

  • Geriatric Medicine (Family Medicine) Physician
  • Tucson, AZ
  • NPI 1841160272
  Medicare reassignment NPD Authorized official
• Full Spectrum Wellness Inc

  • General Practice Physician
  • Tucson, AZ
  • NPI 1447094230
  Medicare reassignment Care Compare group NPD
• Grace Medical Group LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Tucson, AZ
  • NPI 1215603964
  Medicare reassignment Care Compare group NPD
• U2Rworthit1 LLC

  • Primary Care Nurse Practitioner
  • Tucson, AZ
  • NPI 1265187900
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bayada Home Health Care, Inc.

  • Home Health Agency
  • Tucson, AZ
  • NPI 1063743078
  Care Compare affiliation
• Bayada Home Health Care, Inc.

  • Home Health Agency
  • Tucson, AZ
  • NPI 1841221751
  Care Compare affiliation
• Bayada Home Health Care, Inc.

  • Home Health Agency
  • Tucson, AZ
  • NPI 1902847973
  Care Compare affiliation
• Emerald Healthcare Inc.

  • Home Health Agency
  • Tucson, AZ
  • NPI 1972955060
  Care Compare affiliation
• SMSJ Tucson Holdings LLC

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1538535158
  Care Compare affiliation

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

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1356052161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 N WYATT DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857126107",
            "telephone_number": "937-935-7461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 N WYATT DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857126107",
            "telephone_number": "937-935-7461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHLE",
        "first_name": "KIMBERLEY",
        "middle_name": "SUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-13",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "279734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gilbert Jerry Facio, CSA
• Michelle Marie Faddoul, LCSW#16997
• Haind Fadel, MD
• Amit J Fadia, M.D.
• Timothy C Fagan, MD
• Lisa Fail, PT
• Mindy Joy Fain, MD
• Dolores K. Fair, MA, LPC
• Dana Nicole Fairbank, RN
• Nancy Fairbanks

• Family Nurse Practitioner in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.