Individual provider Active NPI

Kimberly Flowers, ANP

  • Gerontology Nurse Practitioner
  • Portland, OR
National Provider Identifier
1366045924
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
10016545 Issued in OR
Practice address
10101 SE Main St Ste 2011
Portland, OR 97216-2457
Phone
(503) 255-3404
Fax
(503) 255-4750
NPI assigned
Nov 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 28168424A IN
Gerontology Nurse Practitioner 363LG0600X 10016545 OR Primary

Addresses

Primary practice location

10101 SE Main St Ste 2011
Portland, OR 97216-2457

Mailing address

10101 SE Main St Ste 2011
Portland, OR 97216-2457
Phone (503) 255-3404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20231219001681 OR Practitioner - Nurse Practitioner 3971916578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Portland Adventist Medical CenterGroup PAC ID 3274908819, 273 clinicians

Practice addresses (Care Compare)

10101 SE Main St
Suite 2011
Portland, OR 97216-2457
Phone (503) 261-6912

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92 of 100Reported as group
Quality
84.7
Promoting interoperability
100
Improvement activities
40
Cost
79.21

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Portland Adventist Medical Center CurrentSince Dec 18, 2023 Accepting new patients
Portland Adventist Medical Center CurrentSince Dec 18, 2023 Accepting new patients

Locations

10151 SE Sunnyside Rd
Ste 100
Clackamas, OR 97015
Phone (503) 659-0880

831 NW Council Dr
Ste 125
Gresham, OR 97030
Phone (503) 661-3439

10101 SE Main St
Ste 2011
Portland, OR 97216
Phone (503) 255-3404

Interoperability endpoints

  • Direct secure messaging: kflowers168307@direct.ohsu.edu

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1366045924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 SE MAIN ST STE 2011",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162457",
            "telephone_number": "503-255-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 SE MAIN ST STE 2011",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162457",
            "telephone_number": "503-255-3404",
            "fax_number": "503-255-4750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOWERS",
        "first_name": "KIMBERLY",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-17",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "28168424A",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OR",
            "license": "10016545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.