Kimberly A Havins, PMHNP-RN-FNP-C

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

617471 Issued in TX

Practice address

1714 10TH St
Wichita Falls, TX 76301-5011

Phone

(940) 766-4482

Fax

(940) 766-4487

NPI assigned

Apr 16, 2007

Last updated

Mar 9, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberly A Otto Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Adam S Butera MD PAGroup PAC ID 6507961000, 7 clinicians

Practice addresses (Care Compare)

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.

• Adam S. Butera MD PA

  • Psychiatry Physician
  • Wichita Falls, TX
  • NPI 1992865992
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457481600000",
    "number": "1659596450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1714 10TH ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763015011",
            "telephone_number": "940-766-4482",
            "fax_number": "940-766-4487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 10TH ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763015011",
            "telephone_number": "940-766-4482",
            "fax_number": "940-766-4487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVINS",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "PMHNP-RN-FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2016-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "617471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "OTTO",
            "middle_name": "A",
            "credential": "RN, FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Peter Marshall Harvey, D.P.M.
• Robert Brooks Harvey, LPC
• Thomas Harwell
• Hosam Hassan
• Brian Lee Hasse, D.D.S.
• Hawkeye Open MRI & Imaging Center, LLC
• Hayley Eye Clinic, P.C. (Hayley Eye Clinic)
• Hayley Eye Clinic, P.C.
• Joe C Hayley, O.D.
• Lauren P Hayley, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Wichita Falls, TX
• Providers in Wichita Falls, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.