Individual provider Active NPI

Kimberley Elaine Boyd

  • Psychiatric/Mental Health Nurse Practitioner
  • Clarksville, TN
National Provider Identifier
1417774076
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
37168 Issued in TN
Practice address
312 Pine Mountain Rd
Clarksville, TN 37042-5221
Phone
(931) 249-0000
NPI assigned
Sep 25, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 37168 TN Primary

Addresses

Primary practice location

312 Pine Mountain Rd
Clarksville, TN 37042-5221

Mailing address

221 S 3Rd St
Clarksville, TN 37040-3601
Phone (931) 304-1670

Other practice location 1

221 S 3rd St
Clarksville, TN 37040-3601
Phone (931) 304-1670

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241211001833 TN Practitioner - Nurse Practitioner 6507392776 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mana Springs Psychiatric Care, LLC Psychiatric/Mental Health CurrentSince Jan 1, 2025 Accepting new patients

Locations

133 Franklin St
Fl 2
Clarksville, TN 37040
Phone (615) 852-6256

133 Franklin St
Clarksville, TN 37040
Phone (615) 852-6256

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1727222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1417774076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 S 3RD ST",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370403601",
            "telephone_number": "931-304-1670",
            "fax_number": "931-903-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 PINE MOUNTAIN RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370425221",
            "telephone_number": "931-249-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "221 S 3rd St",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "TN",
            "postal_code": "370403601",
            "country_code": "US",
            "telephone_number": "931-304-1670",
            "fax_number": "931-903-1200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYD",
        "first_name": "KIMBERLEY",
        "middle_name": "ELAINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-25",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "37168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.