Individual provider Active NPI

Kimberly McMurray, NP

  • Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1699129148
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71006205A Issued in IN
Practice address
7836 W Jefferson Blvd Ste 101
Fort Wayne, IN 46804-4178
Phone
(260) 494-3484
Fax
(260) 969-0188
NPI assigned
Apr 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9246174 FL
Nurse Practitioner 363L00000X APRN9246174 FL
Acute Care Nurse Practitioner 363LA2100X 71006205A IN
Acute Care Nurse Practitioner 363LA2100X APRN.CNP.020413 OH
Gerontology Nurse Practitioner 363LG0600X 71006205A IN
Nurse Practitioner 363L00000X 71006205A IN Primary

Addresses

Primary practice location

7836 W Jefferson Blvd Ste 101
Fort Wayne, IN 46804-4178

Mailing address

120 W 22ND St Ste 200
Oak Brook, IL 60523-1563
Phone (630) 573-5000

Other identifiers 1

IdentifierTypeStateIssuer
0170606MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address credentialing@nephdocs.com Direct
Direct Messaging Address kmcmurray152848@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, OH, MI3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20160513001776 IN Practitioner - Nurse Practitioner 8325337314 Reassigns benefits to 1 organization
I20170905002643 OH Practitioner - Nurse Practitioner 8325337314 Reassigns benefits to 2 organizations
I20230912002358 MI Practitioner - Nurse Practitioner 8325337314 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9246174FLMDRegistered Nurse
APRN9246174FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wood Health Company LLC CurrentSince Sep 1, 2017 Accepting new patients
Hospital Care Group, P.C. CurrentSince Apr 20, 2016 Accepting new patients
Michigan Family Medicine and Urgent Care CurrentSince Aug 9, 2023 Accepting new patients

Locations

416 E Maumee St
Angola, IN 46703
Phone (260) 665-2141

2520 E DuPont Rd
Fort Wayne, IN 46825
Phone (219) 407-8000

6435 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 436-7875

7612 Gratiot Ave
Detroit, MI 48213
Phone (313) 397-1907

6531 W Michigan Ave
#C
Jackson, MI 49201
Phone (517) 750-3822

950 W Wooster St
Bowling Green, OH 43402
Phone (419) 354-8900

745 Haskins Rd
Ste B
Bowling Green, OH 43402
Phone (419) 373-7607

800 W Main St
Coldwater, OH 45828
Phone (419) 678-2341

141 N Keyser Ave
Deshler, OH 43516
Phone (419) 278-2065

1600 E Riverview Ave
Napoleon, OH 43545
Phone (260) 344-3045

915 Michigan St
Sidney, OH 45365
Phone (937) 498-2311

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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": "1461196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1699129148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 22ND ST STE 200",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231563",
            "telephone_number": "630-573-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7836 W JEFFERSON BLVD STE 101",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044178",
            "telephone_number": "260-494-3484",
            "fax_number": "260-969-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMURRAY",
        "first_name": "KIMBERLY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-21",
        "last_updated": "2023-11-03",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9246174",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9246174",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71006205A",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "APRN.CNP.020413",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71006205A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71006205A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0170606",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@nephdocs.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "120 W 22nd St Ste 200",
            "city": "Oak Brook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605231563",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmcmurray152848@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.