Kimberley Christine Roche, PPCNP-BC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

6084 Issued in CT

Practice address

282 Washington St
Connecticut Children's Medical Center
Hartford, CT 06106-3322

Phone

(860) 545-9630

NPI assigned

Sep 4, 2013

Last updated

Apr 15, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Connecticut Children's Specialty Group, Inc.

  • Pediatrics Physician
  • Hartford, CT
  • NPI 1669448882
  Medicare reassignment NPD
• Connecticut Children's Specialty Group, Inc.

  • Ophthalmology Physician
  • Glastonbury, CT
  • NPI 1568056984

  Pediatrics

  NPD
• Connecticut Children's Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Hartford, CT
  • NPI 1578106951
  NPD (past)

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

{
    "created_epoch": "1378252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1649605064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 WASHINGTON ST",
            "address_2": "CONNECTICUT CHILDREN'S MEDICAL CENTER",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 WASHINGTON ST",
            "address_2": "CONNECTICUT CHILDREN'S MEDICAL CENTER",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063322",
            "telephone_number": "860-545-9630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCHE",
        "first_name": "KIMBERLEY",
        "middle_name": "CHRISTINE",
        "credential": "PPCNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-04",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP013071",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "6084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kramjattan16372@connecticutchildrens.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Connecticut Children's Specialty Group, Inc.",
            "address_1": "282 Washington St",
            "address_2": "Connecticut Children's Medical Center",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061063322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rebecca Jennifer Robotham, LCSW
• Jamie Lee Robyn, PA-C
• Daniel Roche
• Jamie Matthew Roche, M.D.
• Kathryn Roche
• Lisa Marie Rochester
• Daniel C Rock, LCSW
• Reuben Rock, M.D.
• Haley Delphine Rodham, PA-C
• Nigel Rodney, NP-C

• Pediatric Nurse Practitioner in Hartford, CT
• Providers in Hartford, CT by specialty
• Pediatric Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.