Individual provider Active NPI

Kimberly Johnson, CRNA

  • Certified Registered Nurse Anesthetist
  • West Palm Beach, FL
National Provider Identifier
1699116657
Registry record updated Jul 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
9314881 Issued in FL
Practice address
3656 Hamilton Ky
West Palm Beach, FL 33411-6466
Phone
(561) 478-3173
NPI assigned
Jul 7, 2013
Last updated
Jul 7, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 9314881 FL Primary

Addresses

Primary practice location

3656 Hamilton Ky
West Palm Beach, FL 33411-6466

Mailing address

3656 Hamilton Ky
West Palm Beach, FL 33411-6466
Phone (561) 478-3173

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201022003810 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183868946 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
9314881FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Anesthesia, PSC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2022 Accepting new patients

Locations

4305 New Shepherdsville Rd
Bardstown, KY 40004
Phone (502) 350-5000

305 Estill St
Berea, KY 40403
Phone (859) 986-1415

55 Foundation Dr
Flemingsburg, KY 41041
Phone (606) 849-2351

1 Saint Joseph Dr
Lexington, KY 40504
Phone (502) 350-5000

1221 S Broadway
Lexington, KY 40504
Phone (859) 258-4181

150 N Eagle Creek Dr
Lexington, KY 40509
Phone (859) 267-9773

2115 Harrodsburg Rd
Lexington, KY 40504
Phone (859) 276-2520

310 S Limestone
Lexington, KY 40508
Phone (606) 252-6612

3475 Blazer Pkwy
Lexington, KY 40509
Phone (859) 514-0260

3480 Yorkshire Medical Park
#100
Lexington, KY 40509
Phone (859) 514-0260

1001 Saint Joseph Ln
London, KY 40741
Phone (606) 330-6000

2511 Terra Crossing Blvd
Louisville, KY 40245
Phone (502) 589-9488

4005 DuPont Cir
Louisville, KY 40207
Phone (502) 897-7401

989 Medical Park Dr
Maysville, KY 41056
Phone (606) 759-3112

225 Falcon Dr
Mt Sterling, KY 40353
Phone (859) 497-5000

1530 Lone Oak Rd
Paducah, KY 42003
Phone (270) 444-2444

175 Hospital Dr
Winchester, KY 40391
Phone (859) 745-3500

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1373155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373155200000",
    "number": "1699116657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3656 HAMILTON KY",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334116466",
            "telephone_number": "561-478-3173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3656 HAMILTON KY",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334116466",
            "telephone_number": "561-478-3173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KIMBERLY",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-07",
        "last_updated": "2013-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "9314881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.