Kimberlee Jeanne Macdonell-Der, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

474060 Issued in NY

Practice address

595 W Main St
Watertown, NY 13601-1335

Phone

(315) 788-1530

NPI assigned

Feb 12, 2021

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1613088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1417540246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 W MAIN ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011335",
            "telephone_number": "315-788-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 W MAIN ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011335",
            "telephone_number": "315-788-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONELL-DER",
        "first_name": "KIMBERLEE",
        "middle_name": "JEANNE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-12",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "474060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karrie O Lyndaker, PHARMACIST
• Maureen Louise Lyng, MC CC-SLP
• M B Kayani Physician PC
• Leby Macaraeg, MD
• Kirsty J Macdonald-Ruparetia, BSW MSM LMSW
• Nichol Lynn Macgregor
• Mercedes Mackin
• Linda Macqueen, NP
• Sabrina Kay Madden, RN
• Magnetic Imaging Center/Open MRI, LLC

• Registered Nurse in Watertown, NY
• Providers in Watertown, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; 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.