Active NPI
Kimberley Lisa Holton
- Home Health Clinical Nurse Specialist
- Milton, WV
National Provider Identifier
1689310062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Clinical Nurse Specialist
- License
- 36572
- Practice address
- 17549 Ashton Upland Rd
Milton, WV 25541-8351 - Phone
- (304) 208-1311
- NPI assigned
- May 9, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Home Health Clinical Nurse Specialist | 364SH0200X | 36572 | WV | Primary |
Addresses
Primary practice location
17549 Ashton Upland Rd
Milton, WV 25541-8351
Mailing address
17549 Ashton Upland Rd
Milton, WV 25541-8351
Phone (304) 208-1311
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 550675666 | Medicaid | WV |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36572 | WV | MD | Home Health Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652054400000",
"number": "1689310062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17549 ASHTON UPLAND RD",
"city": "MILTON",
"state": "WV",
"postal_code": "255418351",
"telephone_number": "304-208-1311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17549 ASHTON UPLAND RD",
"city": "MILTON",
"state": "WV",
"postal_code": "255418351",
"telephone_number": "304-208-1311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLTON",
"first_name": "KIMBERLEY",
"middle_name": "LISA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-09",
"last_updated": "2022-05-09",
"certification_date": "2022-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "364SH0200X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Home Health",
"state": "WV",
"license": "36572",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "550675666",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milton, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.