Kimberly Ann Gonyea, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704153798 Issued in MI

Practice address

3600 E Fulton
Grand Rapids, MI 49546-1322

Phone

(616) 949-4971

Fax

(616) 248-3530

NPI assigned

Aug 29, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Practice roles

Locations

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.

• Age Management of West Michigan PC

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1558700625
  Medicare reassignment NPD
• Metropolitan Hospital

  • General Acute Care Hospital
  • Wyoming, MI
  • NPI 1619923919
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415664000000",
    "number": "1700994860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36115 SCHOOLCRAFT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501216",
            "telephone_number": "734-793-6140",
            "fax_number": "734-402-0254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 E FULTON",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495461322",
            "telephone_number": "616-949-4971",
            "fax_number": "616-248-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONYEA",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2014-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704153798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "KG153798",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arianna Patricia Gomez
• Erica Lynn Gomez
• Lindsay Ann Gomez, LMSW
• Nancy Rosalia Gomez, PA
• Angela Gonda, M.D.
• Caroline Gonynor, PHD, MPH
• Laura Elizabeth Gonyon
• Antonio Gonzales
• Gjenikwa D Gonzales
• Jacob Michael Gonzales, B.A.

• Nurse Practitioner in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2014; 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.