Individual provider Active NPI

Kimberly Hall, NP

  • Family Nurse Practitioner
  • Conroe, TX
National Provider Identifier
1376089318
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP132943 Issued in TX
Practice address
503 Medical Center Blvd Ste 100
Conroe, TX 77304-2928
Phone
(936) 788-1060
Fax
(936) 788-2844
NPI assigned
Jan 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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 AP132943 TX Primary

Addresses

Primary practice location

503 Medical Center Blvd Ste 100
Conroe, TX 77304-2928

Mailing address

395 Westlake Terrace Dr
Conroe, TX 77304-3125
Phone (314) 630-2212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200501001371 TX Practitioner - Nurse Practitioner 4385929314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Affiliates of Family Medicine PAGroup PAC ID 3779528005, 5 clinicians

Practice addresses (Care Compare)

503 Medical Ctr Blvd
Suite 100
Conroe, TX 77304-2928
Phone (936) 788-1060

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Affiliates of Family Medicine PA CurrentSince Jan 5, 2021 Accepting new patients
Ut Physicians PastSince Jan 5, 2021 Accepting new patients

Locations

503 Medical Center Blvd
Ste 100
Conroe, TX 77304
Phone (936) 788-1060

Interoperability endpoints

  • Direct secure messaging: kschlett149029@memorialhermann.direct-ci.com

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": "1484438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1376089318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 WESTLAKE TERRACE DR",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043125",
            "telephone_number": "314-630-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 MEDICAL CENTER BLVD STE 100",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042928",
            "telephone_number": "936-788-1060",
            "fax_number": "936-788-2844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "KIMBERLY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-15",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP132943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.