Kimberly Pezzotti Dewire, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP014948 Issued in PA

Practice address

649 N Lewis Rd
Ste 130
Royersford, PA 19468-1234

Phone

(610) 495-8101

Fax

(610) 495-8106

NPI assigned

Apr 8, 2015

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

Medicare fee-for-service enrollment

Enrolled in PA

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

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

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470787200000",
    "number": "1689060477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "649 N LEWIS RD",
            "address_2": "STE 130",
            "city": "ROYERSFORD",
            "state": "PA",
            "postal_code": "194681234",
            "telephone_number": "610-495-8101",
            "fax_number": "610-495-8106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 N LEWIS RD",
            "address_2": "STE 130",
            "city": "ROYERSFORD",
            "state": "PA",
            "postal_code": "194681234",
            "telephone_number": "610-495-8101",
            "fax_number": "610-495-8106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWIRE",
        "first_name": "KIMBERLY",
        "middle_name": "PEZZOTTI",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-08",
        "last_updated": "2016-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP014948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Royersford, PA
• Providers in Royersford, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.