Kimberly S Roberts, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

21131 Issued in TN

Practice address

111 Front St
Henderson, TN 38340-2313

Phone

(731) 989-2829

Fax

(731) 520-0230

NPI assigned

Apr 13, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anew Family Medical PLLCGroup PAC ID 7012334873, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Anew Family Medical PLLC

  • Rural Health Clinic/Center
  • Middleton, TN
  • NPI 1245805712

  5% Or Greater Direct Ownership Interest, Corporate Officer, Operational/Managerial Control

  CMS ownership
• Anew Family Medical PLLC

  • Rural Health Clinic/Center
  • Henderson, TN
  • NPI 1386260792

  5% Or Greater Direct Ownership Interest, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership

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.

• Anew Family Medical PLLC

  • Rural Health Clinic/Center
  • Henderson, TN
  • NPI 1386260792
  Medicare reassignment Care Compare group NPD
• Anew Family Medical PLLC

  • Rural Health Clinic/Center
  • Middleton, TN
  • NPI 1245805712
  NPD

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

• Jackson Madison County General Hospital

  • General Acute Care Hospital
  • Jackson, TN
  • NPI 1093705428
  Care Compare affiliation

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1407210685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 FRONT ST",
            "city": "HENDERSON",
            "state": "TN",
            "postal_code": "383402313",
            "telephone_number": "731-989-2829",
            "fax_number": "731-520-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 FRONT ST",
            "city": "HENDERSON",
            "state": "TN",
            "postal_code": "383402313",
            "telephone_number": "731-989-2829",
            "fax_number": "731-520-0230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "702 S Main St",
            "address_purpose": "LOCATION",
            "city": "Middleton",
            "state": "TN",
            "postal_code": "380523615",
            "country_code": "US",
            "telephone_number": "731-989-2829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KIMBERLY",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-13",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "21131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lenita W. Powers, R.N.
• Benjamin Reese, PA-C
• Jessica Leigh Reese, WHNP-BC
• Charles Edward Rickard Jr., MSN,APRN,BC
• Cara Rust Roberson, APRN
• Stuart Douglas Rogers, O.D.
• Rose Counseling
• Melina Rose, LCSW
• Sherry L Ross
• Daniel D Salmon, PA

• Family Nurse Practitioner in Henderson, TN
• Providers in Henderson, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.