Olivia Kimble, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN-4547 Issued in HI

Practice address

1010 Spruce St
Espanola, NM 87532-2724

Phone

(505) 367-0340

NPI assigned

Jun 28, 2018

Last updated

Sep 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Olivera Velickovic Other name

Medicare fee-for-service enrollment

Enrolled in NM, HI2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kau HospitalGroup PAC ID 7416945548, 138 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kau Hospital Hospital, Pahala, HI, CCN 121301

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kau Hospital

  • Rural Health Clinic/Center
  • Pahala, HI
  • NPI 1144304338
  Medicare reassignment Care Compare group NPD
• Presbyterian Healthcare Services

  dba Presbyterian Medical Group

  • Internal Medicine Physician
  • Albuquerque, NM
  • NPI 1104802354
  Medicare reassignment NPD
• Presbyterian Healthcare Services

  dba Presbyterian Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1215913470
  NPD
• Kau Hospital

  dba East Hawaii Health Clinic at Puna Kai

  • Rural Health Clinic/Center
  • Pahoa, HI
  • NPI 1285450163
  NPD

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

• Kau Hospital

  • Critical Access Hospital
  • Pahala, HI
  • NPI 1558441311
  Care Compare affiliation

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1356836647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 SPRUCE ST",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875322724",
            "telephone_number": "505-367-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBLE",
        "first_name": "OLIVIA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-28",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "53443",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "F06180294",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-4547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLIVERA",
            "last_name": "VELICKOVIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shanti Shanti Kaur Khalsa, MFT
• Silvia C Khalsa, MD
• Muhammad Atif Khan
• Hykal R Khosravibabadi, DDS
• Kacey Reiko Christina Kim
• Kind Mind Psychotherapy LLC
• David Michael King, D.O.
• Chelsea D Kirby, MD
• Glenna Klein
• Michael John Klinger, CST

• Family Nurse Practitioner in Espanola, NM
• Providers in Espanola, NM by specialty
• Family Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; 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.