Individual provider Active NPI

Kristin Kimma, CRNP, FNP-C

  • Family Nurse Practitioner
  • Reading, PA
National Provider Identifier
1376084640
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP017258 Issued in PA
Practice address
1903 Morgantown Rd
Reading, PA 19607-9620
Phone
(610) 777-4040
NPI assigned
Mar 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP017258 PA Primary

Addresses

Primary practice location

1903 Morgantown Rd
Reading, PA 19607-9620

Mailing address

1014 Meadow Dr
Reading, PA 19605-1004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20170510000810 PA Practitioner - Nurse Practitioner 6406133941 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP017258PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Medical Group CurrentSince May 2, 2019 Accepting new patients
St. Joseph Medical Group CurrentSince May 2, 2019 Accepting new patients

Locations

3970 Perkiomen Ave
Ste 102
Reading, PA 19606
Phone (610) 779-1330

1903 Morgantown Rd
Reading, PA 19607
Phone (610) 777-4040

2500 Bernville Rd
Reading, PA 19605
Phone (610) 378-2300

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.

NPI Registry JSON

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1376084640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 MEADOW DR",
            "city": "READING",
            "state": "PA",
            "postal_code": "196051004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 MORGANTOWN RD",
            "city": "READING",
            "state": "PA",
            "postal_code": "196079620",
            "telephone_number": "610-777-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMMA",
        "first_name": "KRISTIN",
        "credential": "CRNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-20",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP017258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reading, PA

Sources for this page

Verify at the official NPI Registry.