Individual provider Active NPI

Kimberly Swann Brown Maynell, APRN

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1427383744
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN2974432 Issued in FL
Practice address
1 Tampa General Cir
A600
Tampa, FL 33606-3571
Phone
(813) 844-4657
Fax
(813) 844-8047
NPI assigned
Oct 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN2974432 FL Primary

Addresses

Primary practice location

1 Tampa General Cir
A600
Tampa, FL 33606-3571

Mailing address

PO Box 917770
Orlando, FL 32891-0001
Phone (813) 844-4657

Other identifiers 2

IdentifierTypeStateIssuer
101922000MedicaidFL
J0OGHOtherFLBLUE CROSS BLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kbrown8130@direct.tgh.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190211001319 FL Practitioner - Nurse Practitioner 6103164520 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3500 E Fletcher Ave
Suite 100
Tampa, FL 33613-4701
Phone (813) 821-8038

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN2974432FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
University Medical Service Association Inc Current Accepting new patients
University Medical Service Association Inc CurrentSince Jan 7, 2019 Accepting new patients
University Medical Service Association Inc CurrentSince Jan 7, 2019 Accepting new patients
University Medical Service Association Inc Past Accepting new patients

Locations

2 Tampa General Cir
Tampa, FL 33606
Phone (813) 259-8500

3500 E Fletcher Ave
Ste 100
Tampa, FL 33613
Phone (813) 974-1283

4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

5802 N 30th St
Tampa, FL 33610
Phone (813) 236-5100

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: kbrown8130@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 6

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 1

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": "1254700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1427383744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001",
            "telephone_number": "813-844-4657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TAMPA GENERAL CIR",
            "address_2": "A600",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063571",
            "telephone_number": "813-844-4657",
            "fax_number": "813-844-8047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNELL",
        "first_name": "KIMBERLY",
        "middle_name": "SWANN BROWN",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-05",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN2974432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101922000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "J0OGH",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbrown8130@direct.tgh.org",
            "affiliation": "N",
            "address_1": "1 Tampa General Cir",
            "address_2": "A600",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.