Individual provider Active NPI

Kimberly Nicole Williams, APRN, FNP-C

  • Family Nurse Practitioner
  • East Grand Forks, MN
National Provider Identifier
1639693864
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6326 Issued in MN
Practice address
210 Gateway Dr NE Ste 1
East Grand Forks, MN 56721-1621
Phone
(218) 207-2020
NPI assigned
Jul 31, 2017
Last updated
Jul 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R36491 ND
Family Nurse Practitioner 363LF0000X 6326 MN Primary

Addresses

Primary practice location

210 Gateway Dr NE Ste 1
East Grand Forks, MN 56721-1621

Mailing address

210 Gateway Dr NE Ste 1
East Grand Forks, MN 56721-1621
Phone (218) 207-2020

Other names 1

  • Kimberly Nicole Garnett Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20250912004137 MN Practitioner - Nurse Practitioner 0244733319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Balm of Gilead Healthcare Clinic LLCGroup PAC ID 0648635714, 3 clinicians

Practice addresses (Care Compare)

1618 Central Ave NE
East Grand Forks, MN 56721-1335
Phone (218) 779-9437

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R36491NDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Balm of Gilead Healthcare Clinic LLC CurrentSince Jul 21, 2025 Accepting new patients
Myally Health PastSince Nov 1, 2019 Accepting new patients
Balm of Gilead Healthcare LLC Family PastSince Mar 12, 2023 Accepting new patients

Locations

1618 Central Ave NE
East Grand Forks, MN 56721
Phone (218) 779-9437

210 Gateway Dr NE
Ste 1
East Grand Forks, MN 56721
Phone (218) 207-2020

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1639693864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 GATEWAY DR NE STE 1",
            "city": "EAST GRAND FORKS",
            "state": "MN",
            "postal_code": "567211621",
            "telephone_number": "218-207-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 GATEWAY DR NE STE 1",
            "city": "EAST GRAND FORKS",
            "state": "MN",
            "postal_code": "567211621",
            "telephone_number": "218-207-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KIMBERLY",
        "middle_name": "NICOLE",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-31",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R36491",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "6326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "GARNETT",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in East Grand Forks, MN

Sources for this page

Verify at the official NPI Registry.