NPIMap

Individual provider Active NPI

Kimberly Dawn Clymens, NP

  • Nurse Practitioner
  • Denver, NC
National Provider Identifier
1558174243
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5021564 Issued in NC
Practice address
1585 Forney Creek Pkwy Ste 2100
Denver, NC 28037-9520
Phone
(704) 236-6811
NPI assigned
Jan 28, 2025
Last updated
Jan 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 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 5021564 NC Primary

Addresses

Primary practice location

1585 Forney Creek Pkwy Ste 2100
Denver, NC 28037-9520

Mailing address

12706 Willow Grove Way
Huntersville, NC 28078-9637
Phone (704) 236-6811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250325002468 NC Practitioner - Nurse Practitioner 4981127560 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians
Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, shared by 5 NPIs, 540 clinicians

Practice addresses (Care Compare)

1585 Forney Creek Pkwy
Suite 2100
Denver, NC 28037-9520
Phone (980) 212-6230

201 McCullough Dr
Suite 310
Charlotte, NC 28262-3577
Phone (704) 547-1129

3310 Dutch Creek Dr
Charlotte, NC 28215-1667
Phone (704) 403-0710

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5021564NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Mar 24, 2025 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Mar 24, 2025 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients

Locations

3310 Dutch Creek Dr
Charlotte, NC 28215
Phone (704) 403-0710

1585 Forney Creek Pkwy
Ste 2100
Denver, NC 28037
Phone (704) 489-0365

4429 W Highway 27
Vale, NC 28168
Phone (704) 748-2245

Interoperability endpoints

  • Direct secure messaging: kclymens54739@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 4

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 8

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": "1738022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1558174243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12706 WILLOW GROVE WAY",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280789637",
            "telephone_number": "704-236-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 FORNEY CREEK PKWY STE 2100",
            "city": "DENVER",
            "state": "NC",
            "postal_code": "280379520",
            "telephone_number": "704-236-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLYMENS",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-28",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5021564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, NC

Sources for this page

Verify at the official NPI Registry.