Individual provider Active NPI

Kimberly W. Vignola, AGNP

  • Nurse Practitioner
  • Newark, DE
National Provider Identifier
1356718001
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
LP-0000139 Issued in DE
Practice address
4755 Ogletown Stanton Rd
Room E1070 Center for Heart & Vascular Health at Christ
Newark, DE 19718-2200
Phone
(302) 623-1929
Fax
(302) 733-4533
NPI assigned
Aug 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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 LP-0000139 DE Primary

Addresses

Primary practice location

4755 Ogletown Stanton Rd
Room E1070 Center for Heart & Vascular Health at Christ
Newark, DE 19718-2200

Mailing address

200 Hygeia Dr
Suite 2300, CCHS Physician Contracting
Newark, DE 19713-2049

Other practice location 1

424 Savannah Rd
Lewes, DE 19958-1462
Phone (302) 645-3646

Other names 1

  • Kimberly W. Proctor Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20160714001552 DE Practitioner - Nurse Practitioner 2062704810 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services Inc CurrentSince May 24, 2016 Accepting new patients
Christiana Care Health Services, Inc CurrentSince May 24, 2016 Accepting new patients
Christiana Care Health Services, Inc Nurse Practitioner Current Accepting new patients
Beebe Physician Network Inc. CurrentSince Jan 28, 2025 Accepting new patients

Locations

424 Savannah Rd
Lewes, DE 19958
Phone (302) 441-1078

32550 Docs Pl
Unit 2
Millville, DE 19967
Phone (302) 539-4302

4755 Ogletown Stanton Rd
Rm E1070
Newark, DE 19718

4755 Ogletown Stanton Rd
Newark, DE 19718
Phone (302) 733-1700

200 Hygeia Dr
Ste 2300
Newark, DE 19713
Phone (302) 623-7362

4755 Ogletown Stanton Rd
#1E50
Newark, DE 19718
Phone (302) 733-1980

3521 Silverside Rd
Ste 1C
Wilmington, DE 19810
Phone (302) 368-3007

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

Interoperability endpoints

  • Direct secure messaging: kvignola22389@beebehealth.direct-ci.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/5c7467fb-60f9-4172-add4-57667a5dfcfa/

Organizations & group practices 4

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": "1440720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1356718001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HYGEIA DR",
            "address_2": "SUITE 2300, CCHS PHYSICIAN CONTRACTING",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD",
            "address_2": "ROOM E1070 CENTER FOR HEART & VASCULAR HEALTH AT CHRIST",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "302-623-1929",
            "fax_number": "302-733-4533"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "424 Savannah Rd",
            "address_purpose": "LOCATION",
            "city": "Lewes",
            "state": "DE",
            "postal_code": "199581462",
            "country_code": "US",
            "telephone_number": "302-645-3646",
            "fax_number": "302-645-8734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIGNOLA",
        "first_name": "KIMBERLY",
        "middle_name": "W.",
        "name_prefix": "Mrs.",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-28",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LP-0000139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "PROCTOR",
            "middle_name": "W.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.