Kimberly Jean Luedecke, ARNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

ARNP9244528 Issued in FL

Practice address

1917 Boothe Cir
Longwood, FL 32750-6708

Phone

(407) 679-3337

Fax

(407) 678-7246

NPI assigned

Apr 28, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Stages of Life Medical Institute

  • Pain Medicine (Anesthesiology) Physician
  • Longwood, FL
  • NPI 1790968485
  NPD (past)

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398643200000",
    "number": "1386054559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1334 FERENDINA DR",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "32725",
            "telephone_number": "321-689-8013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1917 BOOTHE CIR",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327506708",
            "telephone_number": "407-679-3337",
            "fax_number": "407-678-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUEDECKE",
        "first_name": "KIMBERLY",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-28",
        "last_updated": "2014-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "ARNP9244528",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "ARNP9244528",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loyalty Healthcare LLC
• LPMG Inc
• Aristotle Christopher Luck, DC.
• Amy Julianne Luco
• Kami Lue Sang, ARNP
• Laura Wilson Lumpkins, RD, LD/N
• Samuel Luong, D.C.
• Van M Luong, ARNP
• Sarah Luster
• Lymphedema Clinic of Orlando, Inc

• Acute Care Nurse Practitioner in Longwood, FL
• Providers in Longwood, FL by specialty
• Acute Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.