Individual provider Active NPI

Kimberly Hope Fitterer

  • Family Nurse Practitioner
  • Edgewood, KY
National Provider Identifier
1659044956
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3016308 Issued in KY
Practice address
1 Medical Village Drive
Edgewood, KY 41017-3970
Phone
(859) 301-8074
Fax
(859) 301-4945
NPI assigned
Aug 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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 3016308 KY Primary

Addresses

Primary practice location

1 Medical Village Drive
Edgewood, KY 41017-3970

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 301-8074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20220318000689 KY Practitioner - Nurse Practitioner 2062807506 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3016308KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney Disease Consultants CurrentSince Feb 7, 2022 Accepting new patients

Locations

1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000

47 Cavalier Blvd
Ste 120
Florence, KY 41042
Phone (859) 283-0544

120 Progress Way
Owenton, KY 40359
Phone (502) 227-2229

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.

NPI Registry JSON

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

{
    "created_epoch": "1627776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1659044956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-301-8074",
            "fax_number": "859-301-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL VILLAGE DRIVE",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173970",
            "telephone_number": "859-301-8074",
            "fax_number": "859-301-4945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITTERER",
        "first_name": "KIMBERLY",
        "middle_name": "HOPE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-01",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3016308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.