Individual provider Active NPI

Kimberly Dawn Thomas, DNP, RN, CNS

  • Clinical Nurse Specialist
  • Roanoke, VA
National Provider Identifier
1619399631
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
0024183837 Issued in VA
Practice address
101 Elm Ave SE
Roanoke, VA 24013-2222
Phone
(540) 224-4325
Fax
(540) 224-4399
NPI assigned
Jan 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X 0024183837 VA Primary
Registered Nurse 163W00000X RN60835018 WA
Wound Care Registered Nurse 163WW0000X 0001185685 VA
Wound Care Registered Nurse 163WW0000X AP60835055 WA
Nurse Practitioner 363L00000X AP60835055 WA

Addresses

Primary practice location

101 Elm Ave SE
Roanoke, VA 24013-2222

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713

Other practice location 1

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 632-9000

Other practice location 2

400 S 43rd St
Renton, WA 98055-5714
Phone (425) 690-3650

Other identifiers 1

IdentifierTypeStateIssuer
2135115MedicaidWA

Other names 1

  • Kimbery Dawn Hall Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address khall78027@direct.valleymed.org Direct
FHIR URL khall78027@direct.valleymed.org Other

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150521001322 VA Practitioner - Certified Clinical Nurse Specialist (CNS) 3072833771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001185685VAMDWound Care Registered Nurse
AP60835055WAMDNurse Practitioner
0024183837VAMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: khall78027@direct.valleymed.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1619399631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ELM AVE SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240132222",
            "telephone_number": "540-224-4325",
            "fax_number": "540-224-4399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1906 Belleview Ave SE",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240141838",
            "country_code": "US",
            "telephone_number": "540-632-9000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 S 43rd St",
            "address_purpose": "LOCATION",
            "city": "Renton",
            "state": "WA",
            "postal_code": "980555714",
            "country_code": "US",
            "telephone_number": "425-690-3650",
            "fax_number": "425-690-9650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "credential": "DNP, RN, CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-10",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "VA",
            "license": "0024183837",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60835018",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "VA",
            "license": "0001185685",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "WA",
            "license": "AP60835055",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60835055",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2135115",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khall78027@direct.valleymed.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "khall78027@direct.valleymed.org",
            "address_1": "400 S 43rd St",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980555714",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "khall78027@direct.valleymed.org",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "400 S 43rd St",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980555714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIMBERY",
            "last_name": "HALL",
            "middle_name": "DAWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.