Individual provider Active NPI

Kimberly Ross, NP

  • Adult Health Nurse Practitioner
  • Wilton Manors, FL
National Provider Identifier
1386937555
Registry record updated May 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP2054152 Issued in FL
Practice address
2504 NW 5TH Ave
Wilton Manors, FL 33311-3017
Phone
(754) 367-3774
Fax
(877) 734-2759
NPI assigned
May 22, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP2054152 FL Primary

Addresses

Primary practice location

2504 NW 5TH Ave
Wilton Manors, FL 33311-3017

Mailing address

2504 NW 5TH Ave
Wilton Manors, FL 33311-3017
Phone (754) 367-3774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP2054152FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Yvonne R S Sherrer MD PA Past Accepting new patients
Steven L. Weiner, DC, PA PastSince Jan 10, 1994 Accepting new patients
Midway Medical Associates PA Past Accepting new patients

Organizations & group practices 3

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": "1306022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306022400000",
    "number": "1386937555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 NW 5TH AVE",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333113017",
            "telephone_number": "754-367-3774",
            "fax_number": "877-734-2759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 NW 5TH AVE",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333113017",
            "telephone_number": "754-367-3774",
            "fax_number": "877-734-2759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "KIMBERLY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-22",
        "last_updated": "2011-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP2054152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilton Manors, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2011; 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.