Individual provider Active NPI

Kimberly Anne Greenawalt, ACNP-BC

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1578831954
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9184456 Issued in FL
Practice address
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone
(904) 953-2000
NPI assigned
Dec 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X APRN9184456 FL
Nurse Practitioner 363L00000X APRN9184456 FL Primary

Addresses

Primary practice location

4500 San Pablo Rd S
Jacksonville, FL 32224-1865

Mailing address

PO Box 860912
Minneapolis, MN 55486-0912

Other practice location 1

15255 Max Leggett Pkwy
Jacksonville, FL 32218-7273
Phone (904) 244-0411

Other practice location 2

4205 Belfort Rd
Suite 2069
Jacksonville, FL 32216-1471
Phone (904) 296-0278

Other names 1

  • Kimberly Anne Butterfield Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kgreenawalt2643453@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20150320000507 FL Practitioner - Nurse Practitioner 6709103260 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Florida Jacksonville Physicians, Inc.Group PAC ID 9133025869, 908 clinicians
St Vincent'S Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians
Mayo Clinic JacksonvilleGroup PAC ID 5698689297, 1,595 clinicians

Practice addresses (Care Compare)

15255 Max Leggett Pkwy
Jacksonville, FL 32218-7213
Phone (904) 383-1000

4205 Belfort Rd
Jacksonville, FL 32216-1471
Phone (904) 308-7959

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

653 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-1680

655 W 8TH St
Jacksonville, FL 32209-6511
Phone (940) 244-4218

Hospital & facility affiliations

  • Mayo Clinic Hospital, Jacksonville, FL, CCN 100151

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9184456FLMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Ambulatory Care Inc CurrentSince Mar 2, 2015 Accepting new patients
Mayo Clinic Jacksonville CurrentSince Jan 5, 2026 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Dec 2, 2024 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Dec 2, 2024 Accepting new patients
Mayo Clinic Jacksonville CurrentSince Jan 5, 2026 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Mar 2, 2015 Accepting new patients

Locations

4205 Belfort Rd
Ste 1100
Jacksonville, FL 32216
Phone (904) 296-3103

4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815

4205 Belfort Rd
Ste 4020
Jacksonville, FL 32216
Phone (904) 450-6020

4205 Belfort Rd
Ste 2069
Jacksonville, FL 32216
Phone (904) 296-0278

15255 Max Leggett Pkwy
Jacksonville, FL 32218
Phone (904) 383-1000

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

1658 St Vincents Way
Ste 210
Middleburg, FL 32068
Phone (904) 214-8161

400 Health Park Blvd
St Augustine, FL 32086
Phone (904) 819-4300

Interoperability endpoints

  • Direct secure messaging: kgreenawalt2643453@ehrdirect.mayoclinicmsg.org

Organizations & group practices 8

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": "1323734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1578831954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860912",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15255 Max Leggett Pkwy",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322187273",
            "country_code": "US",
            "telephone_number": "904-244-0411",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4205 Belfort Rd",
            "address_2": "Suite 2069",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322161471",
            "country_code": "US",
            "telephone_number": "904-296-0278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREENAWALT",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "credential": "ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-13",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "FL",
            "license": "APRN9184456",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9184456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgreenawalt2643453@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "4500 San Pablo Rd S",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322241865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "BUTTERFIELD",
            "middle_name": "ANNE",
            "credential": "ACNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.