Individual provider Active NPI

Kimberly Anne Rouleau, ARNP

  • Adult Health Nurse Practitioner
  • Bedford, NH
National Provider Identifier
1528067501
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
041762-23-05 Issued in NH
Practice address
706 Riverway PL
Bedford, NH 03110-6768
Phone
(603) 623-3516
Fax
(603) 623-3580
NPI assigned
Jul 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 041762-23-05 NH Primary

Addresses

Primary practice location

706 Riverway PL
Bedford, NH 03110-6768

Mailing address

706 Riverway PL
Bedford, NH 03110-6768
Phone (603) 623-3516

Other identifiers 4

IdentifierTypeStateIssuer
30011686MedicaidNH
RONH1361OtherNHHARVARD PILGRIM
4000801Y0NH01OtherNHANTHEM
4522244OtherNHCIGNA

Other names 1

  • Kimberly Anne Rouleau Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20101004000417 NH Practitioner - Nurse Practitioner 1850583329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Elliot Professional ServicesGroup PAC ID 6103727920, 429 clinicians

Practice addresses (Care Compare)

1 Elliot Way
Manchester, NH 03103-3502
Phone (603) 622-6484

185 Queen City Ave
Manchester, NH 03101-7121
Phone (603) 314-6900

One Elliot Way
100 Elliot Cardiovascular Consultants
Manchester, NH 03103-3502
Phone (603) 627-1669

Hospital & facility affiliations

  • Elliot Hospital Hospital, Manchester, NH, CCN 300012

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Professional Services CurrentSince Sep 1, 2010 Accepting new patients

Locations

706 Riverway Pl
Bedford, NH 03110
Phone (603) 623-3516

185 Queen City Ave
Manchester, NH 03101
Phone (603) 314-6900

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

Organizations & group practices 1

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1528067501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 RIVERWAY PL",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106768",
            "telephone_number": "603-623-3516",
            "fax_number": "603-623-3580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 RIVERWAY PL",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106768",
            "telephone_number": "603-623-3516",
            "fax_number": "603-623-3580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROULEAU",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NH",
            "license": "041762-23-05",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30011686",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "RONH1361",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "4000801Y0NH01",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4522244",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "ROULEAU",
            "middle_name": "ANNE",
            "credential": "ARNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bedford, NH

Sources for this page

Verify at the official NPI Registry.