Individual provider Active NPI

Kimberly Kiker Painter, PH.D.

  • Psychologist
  • Raleigh, NC
National Provider Identifier
1629103726
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3291 Issued in NC
Practice address
1004 Dresser CT
Suite 103
Raleigh, NC 27609-7325
Phone
(919) 876-5658
Fax
(919) 790-1521
NPI assigned
Feb 22, 2007
Last updated
Jul 16, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3291 NC Primary
Cognitive & Behavioral Psychologist 103TB0200X 3291 NC
Clinical Psychologist 103TC0700X 3291 NC
Counseling Psychologist 103TC1900X 3291 NC
Clinical Child & Adolescent Psychologist 103TC2200X 3291 NC
Family Psychologist 103TF0000X 3291 NC
Intellectual & Developmental Disabilities Psychologist 103TM1800X 3291 NC
Group Psychotherapy Psychologist 103TP2701X 3291 NC

Addresses

Primary practice location

1004 Dresser CT
Suite 103
Raleigh, NC 27609-7325

Mailing address

1004 Dresser CT
Suite 103
Raleigh, NC 27609-7325
Phone (919) 876-5658

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3291NCMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1629103726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 DRESSER CT",
            "address_2": "SUITE 103",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097325",
            "telephone_number": "919-876-5658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 DRESSER CT",
            "address_2": "SUITE 103",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097325",
            "telephone_number": "919-876-5658",
            "fax_number": "919-790-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAINTER",
        "first_name": "KIMBERLY",
        "middle_name": "KIKER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "3291",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NC",
            "license": "3291",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "3291",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NC",
            "license": "3291",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NC",
            "license": "3291",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "NC",
            "license": "3291",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "NC",
            "license": "3291",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NC",
            "license": "3291",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.