Individual provider Active NPI

Kimberly Ann Godsey, CNP

  • Nurse Practitioner
  • Monterey, CA
National Provider Identifier
1720429095
Registry record updated Mar 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95011334 Issued in CA
Practice address
30 Garden CT Ste B
Monterey, CA 93940-5302
Phone
(831) 647-1123
Fax
(831) 886-3647
NPI assigned
Jul 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X COA.14778-NP OH
Nurse Practitioner 363L00000X 95011334 CA Primary

Addresses

Primary practice location

30 Garden CT Ste B
Monterey, CA 93940-5302

Mailing address

30 Garden CT Ste B
Monterey, CA 93940-5302
Phone (831) 647-1123

Other names 1

  • Kimberly Ann Montgomery Former name

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20190422002257 CA Practitioner - Nurse Practitioner 2163665563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Montage Medical GroupGroup PAC ID 6406901941, 125 clinicians

Practice addresses (Care Compare)

30 Garden CT
B
Monterey, CA 93940-5302
Phone (831) 647-1123

Hospital & facility affiliations

  • Central Coast Vna & Hospice, Inc Home health agency, Monterey, CA, CCN 057002
  • Community Hospital of the Monterey Peninsula Hospital, Monterey, CA, CCN 050145

Merit-based Incentive Payment System (MIPS)

Final score
86.59 of 100Reported as group
Quality
81.82
Promoting interoperability
100
Improvement activities
40
Cost
73.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95011334CAMDNurse Practitioner
COA.14778-NPOHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Montage Medical Group CurrentSince Mar 4, 2019 Accepting new patients

Locations

23845 Holman Hwy
Ste 210
Monterey, CA 93940
Phone (831) 620-0296

100 Wilson Rd
Ste 100
Monterey, CA 93940
Phone (831) 242-8301

2 Upper Ragsdale Dr
Bldg E
Monterey, CA 93940
Phone (831) 333-3040

30 Garden Ct
Ste B
Monterey, CA 93940
Phone (831) 647-1123

30 Garden Ct
#B
Monterey, CA 93940
Phone (831) 647-1123

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552608000000",
    "number": "1720429095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 GARDEN CT STE B",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939405302",
            "telephone_number": "831-647-1123",
            "fax_number": "831-886-3647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 GARDEN CT STE B",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939405302",
            "telephone_number": "831-647-1123",
            "fax_number": "831-886-3647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODSEY",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-15",
        "last_updated": "2019-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "COA.14778-NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95011334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "MONTGOMERY",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Monterey, CA

Sources for this page

Verify at the official NPI Registry.