Kimberly Christina Fernandez, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN11029595 Issued in FL

Practice address

4100 Waterman Way
Tavares, FL 32778-5270

Phone

(352) 343-1117

Fax

(866) 445-2968

NPI assigned

Oct 18, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cardiac and Vascular Consultants MD PAGroup PAC ID 0345427019, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles (3 of 5)

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

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.

• Cardiac and Vascular Consultants MD PA

  • Medical Specialty Clinic/Center
  • The Villages, FL
  • NPI 1093006108

  FL

  Medicare reassignment Care Compare group NPD
• Florida Cancer Specialists & Research Institute, LLC

  • Medical Oncology Physician
  • Cape Coral, FL
  • NPI 1760590962

  FL

  Medicare reassignment NPD
• Emcare Inc

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1144570383
  NPD

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

{
    "created_epoch": "1697587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1376325852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102222",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682222",
            "telephone_number": "239-274-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 WATERMAN WAY",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785270",
            "telephone_number": "352-343-1117",
            "fax_number": "866-445-2968"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1340 N Hancock Rd",
            "address_purpose": "LOCATION",
            "city": "Clermont",
            "state": "FL",
            "postal_code": "347115952",
            "country_code": "US",
            "telephone_number": "352-394-1150",
            "fax_number": "352-394-1560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2955 Brownwood Blvd Ste 107",
            "address_purpose": "LOCATION",
            "city": "The Villages",
            "state": "FL",
            "postal_code": "321632040",
            "country_code": "US",
            "telephone_number": "352-765-7100",
            "fax_number": "352-430-0210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "KIMBERLY",
        "middle_name": "CHRISTINA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-18",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9226751",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11029595",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11029595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120457100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family Life Counseling Center LLC
• Family Link Support Service LLC
• Abubaker Shadoul Mohamed Farah, M.D.
• Michael Farfaglia
• Breanna J. Ferguson, D.P.M.
• Britni Filho, APRN
• Florida Cancer Specialists & Research Institute, LLC
• Florida Hospital DME/RT, LLC
• Florida Hospital Home Infusion-Waterman
• Florida Hospital Waterman Inc

• All providers in Tavares, FL
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.