Individual provider Active NPI

Kim T. Kiesel, NP

  • Acute Care Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1457319592
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
71001202A Issued in IN
Practice address
8333 Naab Rd Ste 400
Indianapolis, IN 46260-1992
Phone
(317) 338-6666
Fax
(317) 338-6066
NPI assigned
May 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 71001202A IN Primary
Nurse Practitioner 363L00000X 71001202A IN

Addresses

Primary practice location

8333 Naab Rd Ste 400
Indianapolis, IN 46260-1992

Mailing address

8840 Commerce Park PL Ste E
Indianapolis, IN 46268-3129

Other identifiers 1

IdentifierTypeStateIssuer
200352650MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20080806000143 IN Practitioner - Nurse Practitioner 7719051978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hamiltion Inpatient Physicians LLCGroup PAC ID 2769456771, 19 clinicians

Practice addresses (Care Compare)

395 Westerfield Rd
Noblesville, IN 46060-1425
Phone (317) 776-7446

Hospital & facility affiliations

  • Riverview Health Hospital, Noblesville, IN, CCN 150059

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71001202AINMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hamiltion Inpatient Physicians, LLC CurrentSince Jun 1, 2019 Accepting new patients
Care Group LLC Past Accepting new patients

Locations

395 Westfield Rd
Noblesville, IN 46060
Phone (317) 218-3136

176 W Logan St
Noblesville, IN 46060

Organizations & group practices 2

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.

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1457319592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8840 COMMERCE PARK PL STE E",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462683129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8333 NAAB RD STE 400",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601992",
            "telephone_number": "317-338-6666",
            "fax_number": "317-338-6066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIESEL",
        "first_name": "KIM",
        "middle_name": "T.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71001202A",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71001202A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200352650",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.