Kimberly Ann Washburn, N.P.
Individual provider Active NPI Women's Health Nurse Practitioner · Cortez, CO
NPI 1639315948 · NPPES record last updated Apr 10, 2025
Key facts
- NPI
- 1639315948
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Women's Health Nurse Practitioner 363LW0102X
- License
- C-APN.0001138-C-NP (CO)
- Practice address
- 1311A N Mildred Rd
Cortez, CO 81321-2231 - Phone
- (970) 565-8556
- Fax
- (970) 564-1134
- NPI assigned
- Dec 17, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AZ, CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081215000752 | AZ | Practitioner - Nurse Practitioner | 0941362628 | |
| I20210217001881 | CO | Practitioner - Nurse Practitioner | 0941362628 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| JOH104338485 | AZ | MD | Obstetrics & Gynecology Physician |
| C-APN.0001138-C-NP | CO | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Health System, Inc. | Current | Accepting new patients | |
| Southwest Health System Inc | Obstetrics & Gynecology | Current | Accepting new patients |
| Southwest Health System, Inc. | Current |
Accepting new patients | |
| Southwest Health System, Inc. | Current | Accepting new patients | |
| Southwest Health System, Inc. | Current |
Accepting new patients | |
| Four Corners OB/GYN | Past | Accepting new patients |
Locations
1311 N Mildred Rd
Ste A
Cortez, CO 81321
Phone (970) 564-2681
1311 N Mildred Rd
#A
Cortez, CO 81321
Phone (970) 565-8556
1311 N Mildred Rd
Cortez, CO 81321
Phone (970) 565-6666
1413 N Mildred Rd
Cortez, CO 81321
Phone (970) 564-1037
Interoperability endpoints
- kimberly.washburn.1@22261.direct.athenahealth.com
- https://api.platform.athenahealth.com/22261/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | JOH104338485 | AZ | |
| Women's Health Nurse Practitioner | 363LW0102X | C-APN.0001138-C-NP | CO | Yes |
Addresses
Primary practice location
1311A N Mildred Rd
Cortez, CO 81321-2231
Mailing address
1311A N Mildred Rd
Cortez, CO 81321-2231
Phone (970) 565-8556
Other practice location 1
5300 S Sutter Dr
Ste 11
Show Low, AZ 85901-8050
Phone (928) 537-9844 ext. 209
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 379623 | Medicaid | AZ |
Other names
- Kimberly Ann Johnson
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | swhealth@1239.direct.myezyaccess.com | Direct |
Other providers in Cortez, CO
- Wallace Anesthesia Services Incorporated
- Rachel Renee Wallace
- Walmart Inc.
- Liching Pi Wang
- Crystal Ward
- Jane Henninger Weiland
- Weir Hometown Healthcare LLC
- Ronda Gail Weir
- Shannon Wells
- Shawn G Wells
All providers in Cortez, CO · Women's Health Nurse Practitioner in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.