Individual provider Active NPI

Kimberly C Hightower, NP

  • Nurse Practitioner
  • Austell, GA
National Provider Identifier
1356516272
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN149802 Issued in GA
Practice address
3950 Austell Rd
Austell, GA 30106-1121
Phone
(404) 290-4840
NPI assigned
Apr 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN149802 GA Primary

Addresses

Primary practice location

3950 Austell Rd
Austell, GA 30106-1121

Mailing address

5665 New Northside Dr NW
Ste 320
Atlanta, GA 30328-5831
Phone (770) 874-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20090508000174 GA Practitioner - Nurse Practitioner 5294883849 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN149802GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Em-I Medical Services, LLC Nurse Practitioner CurrentSince Oct 12, 2015 Accepting new patients
Georgia Em-I Medical Services. LLC Nurse Practitioner CurrentSince Oct 12, 2015 Accepting new patients
The Bortolazzo Group, LLC PastSince Feb 9, 2020 Accepting new patients

Locations

200 Allen Memorial Dr
Bremen, GA 30110
Phone (770) 537-5851

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 3

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": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208908800000",
    "number": "1356516272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5665 NEW NORTHSIDE DR NW",
            "address_2": "STE 320",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285831",
            "telephone_number": "770-874-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 AUSTELL RD",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061121",
            "telephone_number": "404-290-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGHTOWER",
        "first_name": "KIMBERLY",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-23",
        "last_updated": "2008-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN149802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

Verify at the official NPI Registry.