Kimberly McDonald, N.P.

Key facts

NPI

1639628704

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

0024174037 (VA)

Practice address

4901 Plank Rd
Fredericksburg, VA 22407-6625

Phone

(540) 870-6540

NPI assigned

Sep 29, 2016

Sex

Female

Sole proprietor

No

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.

• Abc Pediatrics, LLC Pediatrics Physician · Fredericksburg, VA · NPI 1790722130
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 16, 2022.

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1639628704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18454",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154079",
            "telephone_number": "540-870-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 PLANK RD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224076625",
            "telephone_number": "540-870-6540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6100 Harbourside Centre Loop",
            "address_purpose": "LOCATION",
            "city": "Midlothian",
            "state": "VA",
            "postal_code": "231122170",
            "country_code": "US",
            "telephone_number": "804-639-7555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "KIMBERLY",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-29",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001165191",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024174037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

• Pamela S McCullough, N.P.
• Sharon Y McCurdy
• Shannon McDaniel, NP
• Brian McDermott, M.D.
• Michael McDermott, M.D.
• Micah Daniel McDonald, PA-C
• Ryan A McDonnel, DC
• Jordan Wade McDougal, RBT
• Kenneth Michael McDowell, DO
• Kimberly McFadyen, PTA

All providers in Fredericksburg, VA · Family Nurse Practitioner in Virginia