Individual provider Active NPI

Kimberli Mae Spencer, DNP, APRN, FNP

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1376118919
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
258025 Issued in AZ
Practice address
610 E Baseline Rd Ste 5
Phoenix, AZ 85042-6536
Phone
(602) 230-7373
Fax
(602) 441-5836
NPI assigned
May 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 258025 AZ
Family Nurse Practitioner 363LF0000X 258025 AZ Primary

Addresses

Primary practice location

610 E Baseline Rd Ste 5
Phoenix, AZ 85042-6536

Mailing address

3101 N Central Ave Ste 500
Phoenix, AZ 85012-2639
Phone (602) 230-7373

Other practice location 1

635 E Baseline Rd
Phoenix, AZ 85042-6551
Phone (602) 243-7277

Other practice location 2

3330 N 2nd St Ste 601
Phoenix, AZ 85012-2395
Phone (602) 230-7373

Other practice location 3

3033 N Central Ave Ste 700
Phoenix, AZ 85012-2806
Phone (602) 230-7373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20210817002019 AZ Practitioner - Nurse Practitioner 9032514831 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
258025AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Denova Collaborative Health, LLC CurrentSince Aug 27, 2023 Accepting new patients
Denova Collaborative Health, LLC CurrentSince Aug 27, 2023 Accepting new patients

Locations

3033 N Central Ave
Ste 700
Phoenix, AZ 85012
Phone (602) 281-7289

3330 N 2nd St
Ste 601
Phoenix, AZ 85012
Phone (602) 234-3444

3101 N Central Ave
Ste 500
Phoenix, AZ 85012

3101 N Central Ave
Ste 550
Phoenix, AZ 85012

610 E Baseline Rd
Ste C5
Phoenix, AZ 85042

610 E Baseline Rd
Ste 5
Phoenix, AZ 85042

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": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1376118919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 N CENTRAL AVE STE 500",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122639",
            "telephone_number": "602-230-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 E BASELINE RD STE 5",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850426536",
            "telephone_number": "602-230-7373",
            "fax_number": "602-441-5836"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "635 E Baseline Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850426551",
            "country_code": "US",
            "telephone_number": "602-243-7277",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3330 N 2nd St Ste 601",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850122395",
            "country_code": "US",
            "telephone_number": "602-230-7373",
            "fax_number": "602-230-5105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3033 N Central Ave Ste 700",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850122806",
            "country_code": "US",
            "telephone_number": "602-230-7373",
            "fax_number": "602-257-8029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "KIMBERLI",
        "middle_name": "MAE",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-25",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AZ",
            "license": "258025",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "258025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.