Kimberly Pennine

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN50595 Issued in RI

Practice address

975 Waterman Ave
East Providence, RI 02914-1342

Phone

(401) 437-4884

NPI assigned

Oct 14, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1396149704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 KILEY ST",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029112723",
            "telephone_number": "401-481-9329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 WATERMAN AVE",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029141342",
            "telephone_number": "401-437-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINE",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-14",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "RI",
            "license": "RN50595",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "RI",
            "license": "RN50595",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "RI",
            "license": "RN50595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kelly M Pereira, OD
• Luis Alberto Pereira Jr., PA-C

• Registered Nurse in East Providence, RI
• Providers in East Providence, RI by specialty
• Registered Nurse in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.