NPIMap

Individual provider Active NPI

Kimberly Diane Edwards, N.P.

  • Nurse Practitioner
  • Berea, KY
National Provider Identifier
1720064173
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3743P Issued in KY
Practice address
305 Estill St
Berea, KY 40403-1742
Phone
(859) 985-1415
Fax
(859) 986-6752
NPI assigned
Dec 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3743P KY Primary

Addresses

Primary practice location

305 Estill St
Berea, KY 40403-1742

Mailing address

1010 Main St S
MC Kee, KY 40447-7089
Phone (606) 287-7104

Other identifiers 1

IdentifierTypeStateIssuer
78009909MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040617000439 KY Practitioner - Nurse Practitioner 2365426251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Kentucky College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
H2 Rehabilitation Services of Kentucky, LLCGroup PAC ID 5799682688, 187 clinicians
Health Help IncorporatedGroup PAC ID 8224946561, 43 clinicians

Practice addresses (Care Compare)

193 Glades Rd
Berea, KY 40403-2261
Phone (859) 956-1055

305 Estill St
Berea, KY 40403-1742
Phone (859) 986-1415

Hospital & facility affiliations

  • CHI Saint Joseph Berea NF Hospital, Berea, KY, CCN 181329
  • Saint Joseph East Hospital, Lexington, KY, CCN 180143
  • Baptist Health Richmond Hospital, Richmond, KY, CCN 180049

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3743PKYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health Help Incorporated CurrentSince May 18, 2013 Accepting new patients
Health Help Incorporated Current Accepting new patients
Health Help Incorporated CurrentSince May 18, 2013 Accepting new patients
Health Help Incorporated Current Accepting new patients
Health Help Incorporated Current Accepting new patients
Health Help Incorporated Current Accepting new patients
Elderserve, Inc. Past Accepting new patients

Locations

104 Legacy Dr
Berea, KY 40403
Phone (858) 986-2323

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

30 Stacy Lane Rd
Irvine, KY 40336
Phone (606) 723-0665

1010 Main St S
McKee, KY 40447
Phone (606) 287-7104

401 Highland Park Dr
Richmond, KY 40475
Phone (859) 626-7700

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1720064173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 MAIN ST S",
            "city": "MC KEE",
            "state": "KY",
            "postal_code": "404477089",
            "telephone_number": "606-287-7104",
            "fax_number": "606-287-4409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 ESTILL ST",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404031742",
            "telephone_number": "859-985-1415",
            "fax_number": "859-986-6752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "KIMBERLY",
        "middle_name": "DIANE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-19",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3743P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78009909",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berea, KY

Sources for this page

Verify at the official NPI Registry.