Active NPI
Kimberly Lynn Nicoll, M.D.
- Multi-Specialty Clinic/Center
- Lansdowne, VA
National Provider Identifier
1679758809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Multi-Specialty Clinic/Center
- License
- 0101249379
- Practice address
- 19415 Deerfield Ave Ste 209
Lansdowne, VA 20176-8471 - Phone
- (571) 375-6712
- NPI assigned
- Jan 7, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | 0101249379 | VA | Primary |
Addresses
Primary practice location
19415 Deerfield Ave Ste 209
Lansdowne, VA 20176-8471
Mailing address
19415 Deerfield Ave Ste 209
Lansdowne, VA 20176-8471
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101249379 | VA | MD | Multi-Specialty Clinic/Center |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bestpractices, Inc. | Multi-Specialty | Past | Accepting new patients |
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": "1199664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757462400000",
"number": "1679758809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19415 DEERFIELD AVE STE 209",
"city": "LANSDOWNE",
"state": "VA",
"postal_code": "201768471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19415 DEERFIELD AVE STE 209",
"city": "LANSDOWNE",
"state": "VA",
"postal_code": "201768471",
"telephone_number": "571-375-6712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICOLL",
"first_name": "KIMBERLY",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-07",
"last_updated": "2025-09-10",
"certification_date": "2025-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": "VA",
"license": "0101249379",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lansdowne, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.