Kimberly Sue Mitchell, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1097231 Issued in TX

Practice address

1700 Wildcat Dr Ste B
Portland, TX 78374-2838

Phone

(361) 704-6368

NPI assigned

Apr 7, 2023

Last updated

Apr 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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 TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Access Total Care, LLC

  • Family Medicine Physician
  • Corpus Christi, TX
  • NPI 1063928273
  Medicare reassignment NPD
• Access Urgent Care-Kingsville LLC

  • Urgent Care Clinic/Center
  • Kingsville, TX
  • NPI 1679052666
  Medicare reassignment

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

{
    "created_epoch": "1680825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680825600000",
    "number": "1578258307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5014 COUNTY ROAD 2015",
            "city": "ODEM",
            "state": "TX",
            "postal_code": "783704497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 WILDCAT DR STE B",
            "city": "PORTLAND",
            "state": "TX",
            "postal_code": "783742838",
            "telephone_number": "361-704-6368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "KIMBERLY",
        "middle_name": "SUE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-07",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1097231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose Mejia
• Santos R Mendoza, CPHT
• Isabel C Menendez, MD
• Michael L. Mauldin D.D.S.,P.C.
• Alfred E Miller, RPH
• Tamika Mixon, APRN, FNP-C
• James A Mobley, MD
• Candace Rose Montoya, FNP-C
• Martha Moon, RN, FNP
• More Smiles Dental PLLC

• Family Nurse Practitioner in Portland, TX
• Providers in Portland, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.