Individual provider Active NPI

Kimberly Alford Cribbs

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1679980353
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9303401 Issued in FL
Practice address
800 Prudential Dr
Jacksonville, FL 32207-8202
Phone
(904) 755-1461
NPI assigned
Jul 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN9303401 FL Primary

Addresses

Primary practice location

800 Prudential Dr
Jacksonville, FL 32207-8202

Mailing address

800 Prudential Dr FL B11
Jacksonville, FL 32207-8202
Phone (904) 388-6518

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220131001368 FL Practitioner - Nurse Practitioner 6002135688

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Neurology Inc PastSince Feb 21, 2022 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": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1679980353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 PRUDENTIAL DR FL B11",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078202",
            "telephone_number": "904-388-6518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PRUDENTIAL DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078202",
            "telephone_number": "904-755-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIBBS",
        "first_name": "KIMBERLY",
        "middle_name": "ALFORD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-15",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9303401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.