Individual provider Active NPI

Kimberly A Nevells, FNP-BC

  • Family Nurse Practitioner
  • Sanford, ME
National Provider Identifier
1508840091
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP81440 Issued in ME
Practice address
1420 Main St
Sanford, ME 04073-3680
Phone
(207) 850-5744
NPI assigned
Nov 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0390656 ME
Family Nurse Practitioner 363LF0000X CNP81440 ME Primary
Nurse Practitioner 363L00000X CNP81440 ME

Addresses

Primary practice location

1420 Main St
Sanford, ME 04073-3680

Mailing address

360 US Highway 1 Byp Unit 102
Portsmouth, NH 03801-7105
Phone (603) 410-6700

Other identifiers 1

IdentifierTypeStateIssuer
1508840091MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20121214000214 ME Practitioner - Nurse Practitioner 0840442083 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
May accept Medicare assignment
Group practices
Convenientmd - FFS UC LLCGroup PAC ID 5193186492, 397 clinicians
Clearchoicemd, PLLCGroup PAC ID 1850510058, 85 clinicians

Practice addresses (Care Compare)

1420 Main St
Sanford, ME 04073-3680
Phone (207) 850-5744

273 Payne Rd
Scarborough, ME 04074-6593
Phone (207) 618-9355

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0390656MEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Convenientmd - FFS UC LLC CurrentSince Aug 1, 2023 Accepting new patients
Clearchoicemd, PLLC CurrentSince Aug 25, 2025 Accepting new patients
Clearchoicemd, PLLC CurrentSince Aug 25, 2025 Accepting new patients
Webber Hospital Association CurrentSince Nov 16, 2012 Accepting new patients
Mainehealth CurrentSince Nov 16, 2012 Accepting new patients
Mainehealth Current Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Aug 1, 2023 Accepting new patients
Convenientmd - FFS UC LLC Past Accepting new patients

Locations

600 Center St
Auburn, ME 04210
Phone (207) 783-8951

1 Medical Dr
Biddeford, ME 04005
Phone (207) 283-7000

193 Bath Rd
Brunswick, ME 04011
Phone (207) 424-2272

655 Main St
Saco, ME 04072
Phone (207) 283-1407

1420 Main St
Sanford, ME 04073
Phone (207) 850-5744

273 Payne Rd
Scarborough, ME 04074
Phone (207) 289-6133

950 Main St
Westbrook, ME 04092
Phone (207) 517-3800

360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700

111 New Hampshire Ave
Portsmouth, NH 03801

Interoperability endpoints

  • Direct secure messaging: knevells157012@direct.mmc.mainehealth.org

Organizations & group practices 8

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": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1508840091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 US HIGHWAY 1 BYP UNIT 102",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017105",
            "telephone_number": "603-410-6700",
            "fax_number": "603-319-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 MAIN ST",
            "city": "SANFORD",
            "state": "ME",
            "postal_code": "040733680",
            "telephone_number": "207-850-5744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVELLS",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ME",
            "license": "0390656",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP81440",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ME",
            "license": "CNP81440",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508840091",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, ME

Sources for this page

Verify at the official NPI Registry.