Individual provider Active NPI

Kimberly Queen, NP

  • Nurse Practitioner
  • Augusta, GA
National Provider Identifier
1538677679
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN208769 Issued in GA
Practice address
3624 J Dewey Gray Cir Ste 220
Augusta, GA 30909
Phone
(706) 650-7442
NPI assigned
Jan 10, 2018
Last updated
Aug 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 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 RN208769 GA Primary

Addresses

Primary practice location

3624 J Dewey Gray Cir Ste 220
Augusta, GA 30909

Mailing address

3624 J Dewey Gray Cir Ste 220
Augusta, GA 30909-6586
Phone (706) 650-7442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20180702003494 GA Practitioner - Nurse Practitioner 4587910658 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Augusta Primary Care Services LLCGroup PAC ID 2466513874, 37 clinicians

Practice addresses (Care Compare)

3624 J Dewey Gray Cir
Suite 220
Augusta, GA 30909-6586
Phone (706) 650-7442

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Helping Hands Hospice LLC CurrentSince Aug 25, 2024 Accepting new patients
Augusta Primary Care Services LLC CurrentSince Aug 25, 2025 Accepting new patients

Locations

1350 Augusta West Pkwy
Augusta, GA 30909
Phone (706) 432-8321

3623 J Dewey Gray Cir
Ste 210
Augusta, GA 30909
Phone (706) 651-5780

3624 J Dewey Gray Cir
Ste 220
Augusta, GA 30909
Phone (706) 650-7442

3642 Wheeler Rd
Augusta, GA 30909
Phone (706) 408-5759

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: kimberly.queen@hca5.eclinicaldirectplus.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1515542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1538677679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3624 J DEWEY GRAY CIR STE 220",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096586",
            "telephone_number": "706-650-7442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3624 J DEWEY GRAY CIR STE 220",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "30909",
            "telephone_number": "706-650-7442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEEN",
        "first_name": "KIMBERLY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-10",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN208769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.