Individual provider Active NPI

Kimberly Renee Hinton, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Lake Wales, FL
National Provider Identifier
1629484175
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9244102 Issued in FL
Practice address
408 S 1St St
Lake Wales, FL 33853-4146
Phone
(863) 353-1394
Fax
(863) 638-5722
NPI assigned
Jul 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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 9244102 FL Primary

Addresses

Primary practice location

408 S 1St St
Lake Wales, FL 33853-4146

Mailing address

408 S 1St St
Lake Wales, FL 33853-4146
Phone (863) 354-1394

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230608000286 FL Practitioner - Nurse Practitioner 9133586001 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suma and Durga, PAGroup PAC ID 8426185505, 5 clinicians
Sage Infusion, LLCGroup PAC ID 1254660467, 44 clinicians

Practice addresses (Care Compare)

408 S 1St St
Lake Wales, FL 33853-4146
Phone (863) 353-1394

910 Old Camp Rd
Suite 196
The Villages, FL 32162-5605
Phone (352) 565-5553

Hospital & facility affiliations

  • Adventhealth Heart of Florida Hospital, Davenport, FL, CCN 100137
  • Adventhealth Lake Wales Hospital, Lake Wales, FL, CCN 100099
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9244102FLMDFamily Nurse Practitioner

Practice roles (3 of 4)

OrganizationSpecialtyStatusNew patients
Central Florida Kidney Specialists Inc CurrentSince Sep 11, 2025 Accepting new patients
Sage Infusion, LLC CurrentSince May 10, 2023 Accepting new patients
Suma & Durga PA CurrentSince May 24, 2025 Accepting new patients

Locations

2243 North Blvd W
Davenport, FL 33837
Phone (863) 270-1339

1090 NW 8th Ave
Ste 30
Gainesville, FL 32601
Phone (352) 450-8886

408 S 1st St
Lake Wales, FL 33853
Phone (863) 353-1394

3885 Oakwater Cir
Orlando, FL 32806
Phone (407) 816-5700

4728 N Habana Ave
Ste 101B
Tampa, FL 33614
Phone (813) 775-9997

910 Old Camp Rd
Ste 196
The Villages, FL 32162
Phone (352) 565-5553

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1404518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1629484175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 S 1ST ST",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534146",
            "telephone_number": "863-354-1394",
            "fax_number": "863-638-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 S 1ST ST",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534146",
            "telephone_number": "863-353-1394",
            "fax_number": "863-638-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINTON",
        "first_name": "KIMBERLY",
        "middle_name": "RENEE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-05",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9244102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

Verify at the official NPI Registry.