Active NPI
Kimberly Hearon
- Registered Nurse
- Cordova, TN
National Provider Identifier
1548876303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 0000243985
- Practice address
- 6890 Lagrange Grove Dr
Cordova, TN 38018-2875 - Phone
- (901) 530-5201
- NPI assigned
- Sep 17, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 0000243985 | TN | Primary |
Addresses
Primary practice location
6890 Lagrange Grove Dr
Cordova, TN 38018-2875
Mailing address
6890 Lagrange Grove Dr
Cordova, TN 38018-2875
Phone (901) 530-5201
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000243985 | TN | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600300800000",
"number": "1548876303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6890 LAGRANGE GROVE DR",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380182875",
"telephone_number": "901-530-5201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6890 LAGRANGE GROVE DR",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380182875",
"telephone_number": "901-530-5201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEARON",
"first_name": "KIMBERLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-17",
"last_updated": "2020-09-17",
"certification_date": "2020-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TN",
"license": "0000243985",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cordova, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.