Active NPI
Kimberly Dawn Thomas, DNP, RN, CNS
- Clinical Nurse Specialist
- Roanoke, VA
National Provider Identifier
1619399631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Nurse Specialist
- License
- 0024183837
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2135115 | Medicaid | WA |
Other names 1
- Kimbery Dawn Hall
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 0001185685 | VA | MD | Wound Care Registered Nurse |
| AP60835055 | WA | MD | Nurse Practitioner |
| 0024183837 | VA | MD | Clinical Nurse Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Multicare Health System | Current | Accepting new patients |
Interoperability endpoints
- 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.
-
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- Tacoma, WA
- NPI 1497766638
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.