Individual provider Active NPI

Kimberly Nackord, AG-ACNP-BC

  • Acute Care Nurse Practitioner
  • Walnut Creek, CA
National Provider Identifier
1407305980
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95004760 Issued in CA
Practice address
1601 Ygnacio Valley Rd
Walnut Creek, CA 94598-3122
Phone
(925) 939-3000
NPI assigned
Sep 26, 2016
Last updated
Mar 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95004760 CA Primary

Addresses

Primary practice location

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598-3122

Mailing address

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598-3122
Phone (925) 939-3000

Other practice location 1

1450 Treat Blvd # 250A
Walnut Creek, CA 94597-2168
Phone (925) 988-7522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20220517002875 CA Practitioner - Nurse Practitioner 4284011008 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
John Muir Physician NetworkGroup PAC ID 6608789813, 488 clinicians

Practice addresses (Care Compare)

1450 Treat Blvd
Suite 250a
Walnut Creek, CA 94597-2168
Phone (925) 296-9740

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.32 of 100Reported as group
Quality
89.54
Promoting interoperability
100
Improvement activities
40
Cost
74.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
John Muir Physician Network CurrentSince Apr 7, 2024 Accepting new patients
Bay Area Neurointensivists Inc CurrentSince Jun 1, 2022 Accepting new patients
Moussa F Yazbeck MD Inc Past Accepting new patients
Brandon McCutcheon MD PC Past Accepting new patients

Locations

2400 Balfour Rd
Ste 120
Brentwood, CA 94513
Phone (925) 308-8112

1450 Treat Blvd
Ste 250A
Walnut Creek, CA 94597
Phone (925) 296-9706

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

323 Lennon Ln
Walnut Creek, CA 94598
Phone (925) 430-5335

Interoperability endpoints

  • Direct secure messaging: knackord14679@ehr.johnmuirhealth.com

Organizations & group practices 4

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 3

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": "1474848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1407305980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 YGNACIO VALLEY RD",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983122",
            "telephone_number": "925-939-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 YGNACIO VALLEY RD",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983122",
            "telephone_number": "925-939-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1450 Treat Blvd # 250A",
            "address_purpose": "LOCATION",
            "city": "Walnut Creek",
            "state": "CA",
            "postal_code": "945972168",
            "country_code": "US",
            "telephone_number": "925-988-7522",
            "fax_number": "925-988-7523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NACKORD",
        "first_name": "KIMBERLY",
        "credential": "AG-ACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-26",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95004760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.