Individual provider Active NPI

Gina Marie Kimmey X, APN

  • Acute Care Nurse Practitioner
  • Hines, IL
National Provider Identifier
1730426115
Registry record updated Jan 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
209010153 Issued in IL
Practice address
5000 S 5TH Ave
Edward Hines Jr. Hospital Sicu
Hines, IL 60141-3030
Phone
(312) 405-3710
NPI assigned
Jan 6, 2013
Last updated
Jan 6, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2013

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 209010153 IL Primary
Registered Nurse 163W00000X 041322816 IL

Addresses

Primary practice location

5000 S 5TH Ave
Edward Hines Jr. Hospital Sicu
Hines, IL 60141-3030

Mailing address

835 N Wood St
#301
Chicago, IL 60622-5022
Phone (312) 226-8312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
041322816ILMDRegistered Nurse
209010153ILMDAcute Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1357430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357430400000",
    "number": "1730426115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 N WOOD ST",
            "address_2": "#301",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606225022",
            "telephone_number": "312-226-8312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 S 5TH AVE",
            "address_2": "EDWARD HINES JR. HOSPITAL SICU",
            "city": "HINES",
            "state": "IL",
            "postal_code": "601413030",
            "telephone_number": "312-405-3710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMMEY",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "name_suffix": "X",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-06",
        "last_updated": "2013-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209010153",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041322816",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.