Kimberly Diane Altizer, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

0024174933 Issued in VA

Practice address

104 Carolina Ave
Brookneal, VA 24528-2643

Phone

(434) 376-2325

NPI assigned

Jul 3, 2017

Last updated

Jul 3, 2017By 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 VA

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centra Medical Group LLCGroup PAC ID 4789606088, 709 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centra Health - Lynchburg Gen Hospital Hospital, Lynchburg, VA, CCN 490021

Merit-based Incentive Payment System (MIPS)

Final score

93.16 of 100Reported as apm

Quality

83.58

Promoting interoperability

94

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Centra Medical Group, LLC

  • Family Medicine Physician
  • Lynchburg, VA
  • NPI 1649228966
  Medicare reassignment Care Compare group NPD
• Centra Medical Group, LLC

  dba CMG Weight Loss Services - Langhorne

  • Obesity Medicine (Family Medicine) Physician
  • Lynchburg, VA
  • NPI 1598559452
  NPD (past)

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

• Centra Health Inc

  • General Acute Care Hospital
  • Lynchburg, VA
  • NPI 1770693939
  Care Compare affiliation
• Centra Health Professional Services, LLC

  dba Centra Health Cardiothoracic Surgery

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Lynchburg, VA
  • NPI 1407884448

  Hospital

  Care Compare affiliation
• Centra Health Professional Services, LLC

  dba The Pain Center

  • Pain Medicine (Anesthesiology) Physician
  • Lynchburg, VA
  • NPI 1811925852

  Hospital

  Care Compare affiliation
• Centra Health Professional Services, LLC

  dba The Wound Care Center

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Lynchburg, VA
  • NPI 1902834948

  Hospital

  Care Compare affiliation
• Centra Medical Group, LLC

  dba CMG Vascular Surgery

  • Vascular Surgery Physician
  • Lynchburg, VA
  • NPI 1144880782

  Hospital

  Care Compare affiliation
• Centra Medical Group, LLC

  dba Centra Medical Group Stroobants Cardiovascular Center

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Lynchburg, VA
  • NPI 1184964124

  Hospital

  Care Compare affiliation
• Centra Medical Group, LLC

  dba Centra Lynchburg Hematology and Oncology

  • Hematology & Oncology Physician
  • Lynchburg, VA
  • NPI 1700293628

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1499040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499040000000",
    "number": "1609397462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "443 CARRIAGE PKWY",
            "city": "RUSTBURG",
            "state": "VA",
            "postal_code": "245884573",
            "telephone_number": "434-907-5614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 CAROLINA AVE",
            "city": "BROOKNEAL",
            "state": "VA",
            "postal_code": "245282643",
            "telephone_number": "434-376-2325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTIZER",
        "first_name": "KIMBERLY",
        "middle_name": "DIANE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-03",
        "last_updated": "2017-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024174933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paulina Amoah
• Laura Ann Elizabeth Broggin, CERTIFIED DOULA
• Brookneal Drug Co Inc
• Brookneal Life Care Corp
• Brookneal Optical, Inc

• Nurse Practitioner in Brookneal, VA
• Providers in Brookneal, VA by specialty
• Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.