Individual provider Active NPI

Kimberly Gamble Murdock, NP-C

  • Adult Health Nurse Practitioner
  • Macon, GA
National Provider Identifier
1366716029
Registry record updated Feb 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN138265 Issued in GA
Practice address
140 N Crest Blvd
Macon, GA 31210-1845
Phone
(478) 951-3672
Fax
(478) 757-8353
NPI assigned
Feb 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN138265 GA Primary

Addresses

Primary practice location

140 N Crest Blvd
Macon, GA 31210-1845

Mailing address

140 N Crest Blvd
Macon, GA 31210-1845
Phone (478) 951-3672

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
I20240131002559 GA Practitioner - Nurse Practitioner 1355668195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gabriel Primary CareGroup PAC ID 5294197265, 7 clinicians

Practice addresses (Care Compare)

101 Gateway Dr
Macon, GA 31210-1141
Phone (478) 378-0829

Hospital & facility affiliations

  • Atrium Health Navicent the Medical Center Hospital, Macon, GA, CCN 110107

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gabriel Primary Care CurrentSince Jan 23, 2024 Accepting new patients
Collier B. Gladin, Jr., M.D., LLC PastSince Jul 26, 2022 Accepting new patients

Locations

101 Gateway Dr
Macon, GA 31210
Phone (478) 210-1670

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 1

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": "1330387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330387200000",
    "number": "1366716029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 N CREST BLVD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312101845",
            "telephone_number": "478-951-3672",
            "fax_number": "478-757-8353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 N CREST BLVD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312101845",
            "telephone_number": "478-951-3672",
            "fax_number": "478-757-8353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURDOCK",
        "first_name": "KIMBERLY",
        "middle_name": "GAMBLE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-28",
        "last_updated": "2012-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN138265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.