Individual provider Active NPI

Kimberly McPhearson, D.O.

  • Neurocritical Care Physician
  • Jacksonville, FL
National Provider Identifier
1396196937
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurocritical Care PhysicianTaxonomy code 2084A2900X
License
OS16433 Issued in FL
Practice address
655 W 8TH St
Jacksonville, FL 32209-6511
Phone
(904) 244-0411
NPI assigned
Jun 24, 2016
Last updated
Nov 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 6287 OK
Internal Medicine Physician 207R00000X OS16433 FL
Neurocritical Care Physician 2084A2900X OS16433 FL Primary

Addresses

Primary practice location

655 W 8TH St
Jacksonville, FL 32209-6511

Mailing address

PO Box 44008
Jacksonville, FL 32231-4008

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191218001809 FL Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Neurology 9436401767 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Neurology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Shircliff Way
Jacksonville, FL 32204-4748
Phone (904) 308-7300

400 Health Park Blvd
St Augustine, FL 32086-5784
Phone (904) 819-4442

653 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-1680

655 W 8TH St
Jacksonville, FL 32209-6511
Phone (940) 244-4218

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS16433FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Jacksonville, LLC Internal Medicine CurrentSince Nov 20, 2019 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Internal Medicine Current Accepting new patients
Sound Physicians of Florida IV, LLC Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
Sound Physicians of Florida IV, LLC Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Aug 10, 2022 Accepting new patients
Cogent Healthcare of Jacksonville, LLC Internal Medicine CurrentSince Nov 20, 2019 Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Aug 10, 2022 Accepting new patients
Michigan Post-Acute Medical Services 1 PC Past Accepting new patients

Locations

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

15255 Max Leggett Pkwy
Jacksonville, FL 32218
Phone (904) 383-1000

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

3100 E Fletcher Ave
#C
Tampa, FL 33613
Phone (813) 971-6000

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1396196937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCPHEARSON",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-24",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "6287",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS16433",
            "primary": false
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "FL",
            "license": "OS16433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.