Kimberly Renee White, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R133677 Issued in MD

Practice address

600 Reisterstown Rd
Pikesville, MD 21208-5104

Phone

(410) 602-5139

NPI assigned

Apr 13, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, DC2 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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Core Family Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
  • NPI 1821759671

  Single Specialty

  Medicare reassignment NPD Authorized official
• Optimal Mental Health Group LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
  • NPI 1851038632
  NPD Authorized official
• Kirstin'S Haven, Inc

  • Case Management Agency
  • Camp Springs, MD
  • NPI 1225585136

  DC

  Medicare reassignment
• Core Family Services, LLC

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Baltimore, MD
  • NPI 1396437448
  NPD (past) Authorized official
• Core Family Services, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Baltimore, MD
  • NPI 1437841665
  NPD (past) Authorized official
• Core Family Services, LLC

  • Community/Behavioral Health Agency
  • Baltimore, MD
  • NPI 1477208247
  NPD (past) Authorized official
• Core Family Services, LLC

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
  • NPI 1568185965
  NPD (past) Authorized official
• Core Family Services, LLC

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
  • NPI 1740973999
  NPD (past) Authorized official

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1730769647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2157 STREAMWAY CT",
            "city": "GWYNN OAK",
            "state": "MD",
            "postal_code": "212076093",
            "telephone_number": "443-801-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 REISTERSTOWN RD",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212085104",
            "telephone_number": "410-602-5139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KIMBERLY",
        "middle_name": "RENEE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R133677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• White Marsh Healthcare Physical Medicine,LLC
• Ashley L White
• Jelani Jabari Adisa White
• Jordan White
• Katlin Michele White
• Rebecca Cynthia White, PT, DPT
• Taylor Ashley White
• Terence Robert Edward White
• Valencia White
• Diana Alexander Whitehead, MD

• Psychiatric/Mental Health Nurse Practitioner in Pikesville, MD
• Providers in Pikesville, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.