Kimberly A Mitchell, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

277227 Issued in AZ

Practice address

18555 N 79TH Ave Ste B108
Glendale, AZ 85308-8372

Phone

(888) 705-8558

Fax

(480) 776-0025

NPI assigned

Jun 29, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Alliance Medical Clinic LLCGroup PAC ID 1557374931, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8857/brand/1/csg/1/fhir/r4
• Direct secure messaging: kimberly.mitchell.1@8857.direct.athenahealth.com

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.

• Alliance Medical Clinic, LLC

  • Internal Medicine Physician
  • Anthem, AZ
  • NPI 1740224054
  Medicare reassignment Care Compare group NPD
• Healthy Outlook Family Medicine, PC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1023161825
  Medicare reassignment NPD

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1518699479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 E BASELINE RD # 101",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831503",
            "telephone_number": "888-705-8558",
            "fax_number": "480-776-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18555 N 79TH AVE STE B108",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088372",
            "telephone_number": "888-705-8558",
            "fax_number": "480-776-0025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "277227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sasha Mishler
• Nikita Mishra
• Kiran Mistry, PHARMD
• Misty Adame LPC
• Mitchell Chiropractic LLC
• Mark Joseph Mitchell, PA-C
• Sasha Mitchell, N.D.
• Scott Aaron Mitchell, D.C.
• Yoshica Mitchell
• Derek James Mitzel, M.D.

• Nurse Practitioner in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.