Individual provider Active NPI

Kimberley Mullins, FNP-C

  • Family Nurse Practitioner
  • Montgomery, AL
National Provider Identifier
1639948409
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-136196 Issued in AL
Practice address
445 Dexter Avenue
Suite 4050
Montgomery, AL 36104
Phone
(205) 441-1088
NPI assigned
Dec 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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 1-136196 AL Primary

Addresses

Primary practice location

445 Dexter Avenue
Suite 4050
Montgomery, AL 36104

Mailing address

3590B Pelham Pkwy Ste 240
Pelham, AL 35124-2034
Phone (205) 441-1088

Other names 1

  • Kimberley Barden Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20240315002197 AL Practitioner - Nurse Practitioner 4587000211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
American Wound Care Al PLLCGroup PAC ID 9032554902, 7 clinicians

Practice addresses (Care Compare)

324 Commons Dr
Suite 37
Birmingham, AL 35209-6962
Phone (855) 479-4217

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Hoover, AL, CCN 017009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-136196ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Wound Care Al, PLLC CurrentSince Dec 31, 2023 Accepting new patients

Locations

324 Commons Dr
Ste 37
Birmingham, AL 35209

445 Dexter Ave
Ste 4050
Montgomery, AL 36104
Phone (205) 854-1361

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.

Hospital & facility affiliations 1

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": "1703116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1639948409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3590B PELHAM PKWY STE 240",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351242034",
            "telephone_number": "205-441-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 DEXTER AVENUE",
            "address_2": "SUITE 4050",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "36104",
            "telephone_number": "205-441-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "KIMBERLEY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-21",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-136196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLEY",
            "last_name": "BARDEN",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.