NPIMap

Individual provider Active NPI

Kimberly Nicole Dale, APRN

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1609185628
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3006840 Issued in KY
Practice address
3920 Dutchmans LN Ste 315
Louisville, KY 40207-4702
Phone
(502) 749-7909
NPI assigned
Sep 27, 2010
Last updated
Jul 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3006840 KY Primary

Addresses

Primary practice location

3920 Dutchmans LN Ste 315
Louisville, KY 40207-4702

Mailing address

PO Box 909
Louisville, KY 40201-0909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20110425000278 KY Practitioner - Nurse Practitioner 1951586601 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

908 Dupont Rd
Louisville, KY 40207-4602
Phone (502) 749-7909

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kiosk Medicine Kentucky LLC Family CurrentSince Nov 4, 2013 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Sep 18, 2020 Accepting new patients
University of Louisville Physicians, Inc. Current Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Sep 18, 2020 Accepting new patients
University of Louisville Physicians Inc. Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

10100 Dixie Hwy
Louisville, KY 40272
Phone (502) 637-1005

1505 S 7th St
Louisville, KY 40208
Phone (502) 637-1005

3039 Breckenridge Ln
Louisville, KY 40220
Phone (502) 451-4555

3920 Dutchmans Ln
Ste 315
Louisville, KY 40207
Phone (502) 583-8005

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

908 DuPont Rd
Louisville, KY 40207
Phone (502) 559-1855

Organizations & group practices 5

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 36

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1609185628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 DUTCHMANS LN STE 315",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074702",
            "telephone_number": "502-749-7909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALE",
        "first_name": "KIMBERLY",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-27",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3006840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.