Individual provider Active NPI

Kimberly Janean King, FNP

  • Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1508306952
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2016044352 Issued in MO
Practice address
11133 Dunn Rd
Dept Emergency Med
Saint Louis, MO 63136-6163
Phone
(314) 362-9123
Fax
(314) 747-9160
NPI assigned
Mar 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2016044352 MO Primary

Addresses

Primary practice location

11133 Dunn Rd
Dept Emergency Med
Saint Louis, MO 63136-6163

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 362-9123

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171005003201 MO Practitioner - Nurse Practitioner 9830464551 Reassigns benefits to 4 organizations
I20180621000212 IL Practitioner - Nurse Practitioner 9830464551 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington University Community Specialists LLCGroup PAC ID 8628588514, 94 clinicians
Cep America LLCGroup PAC ID 6608056171, 995 clinicians
Emergency Services Midwest SCGroup PAC ID 2769746056, 37 clinicians

Practice addresses (Care Compare)

11133 Dunn Rd
Saint Louis, MO 63136-6163
Phone (314) 362-9123

12303 De Paul Dr
Bridgeton, MO 63044-2512
Phone (314) 344-6000

4500 Memorial Dr
Belleville, IL 62226-5360
Phone (618) 257-5644

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Heights Medical Group SC Current Accepting new patients
Cep America, LLC Current Accepting new patients
Cep America LLC CurrentSince Nov 1, 2024 Accepting new patients
Southeastern Emergency Services of Memphis, P.C. Nurse Practitioner CurrentSince Oct 1, 2017 Accepting new patients
Fairview Heights Medical Group SC CurrentSince Jul 1, 2022 Accepting new patients
Southeastern Emergency Physicians of Memphis LLC Nurse Practitioner CurrentSince Aug 1, 2024 Accepting new patients
Emergency Services Midwest SC Nurse Practitioner CurrentSince May 2, 2018 Accepting new patients
Cep America LLC CurrentSince Nov 1, 2024 Accepting new patients
Washington University Community Specialists, LLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

1225 Graham Rd
#U
Florissant, MO 63031

660 S Euclid Ave
Saint Louis, MO 63110

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

11133 Dunn Rd
#U
Saint Louis, MO 63136

Organizations & group practices 9

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": "1488672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1508306952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-362-9123",
            "fax_number": "314-747-9160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11133 DUNN RD",
            "address_2": "DEPT EMERGENCY MED",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366163",
            "telephone_number": "314-362-9123",
            "fax_number": "314-747-9160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "KIMBERLY",
        "middle_name": "JANEAN",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-05",
        "last_updated": "2025-07-14",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2016044352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "11133 Dunn Rd",
            "address_2": "Dept Emergency Med",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631366163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.