Individual provider Active NPI

Kristen E Shimp, CRNP

  • Obstetrics & Gynecology Nurse Practitioner
  • West Reading, PA
National Provider Identifier
1740254119
Registry record updated Aug 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
SP008030 Issued in PA
Practice address
301 Penn Ave
Suite 200
West Reading, PA 19611-1264
Phone
(610) 898-7560
Fax
(610) 898-7561
NPI assigned
Feb 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5003904 NC
Obstetrics & Gynecology Nurse Practitioner 363LX0001X SP008030 PA Primary

Addresses

Primary practice location

301 Penn Ave
Suite 200
West Reading, PA 19611-1264

Mailing address

50 Commerce Dr
Wyomissing, PA 19610-3335
Phone (610) 372-8044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040128000512 PA Practitioner - Nurse Practitioner 1850294828

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5003904NCMDFamily Nurse Practitioner
SP008030PAMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kimmel Nasal and Sinus Center CurrentSince Jun 1, 2012 Accepting new patients
The Reading Hospital Medical Group Past Accepting new patients

Locations

2211 Quarry Dr
Ste E58C
West Lawn, PA 19609
Phone (484) 773-1141

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314576000000",
    "number": "1740254119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 COMMERCE DR",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103335",
            "telephone_number": "610-372-8044",
            "fax_number": "484-334-7026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PENN AVE",
            "address_2": "SUITE 200",
            "city": "WEST READING",
            "state": "PA",
            "postal_code": "196111264",
            "telephone_number": "610-898-7560",
            "fax_number": "610-898-7561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMP",
        "first_name": "KRISTEN",
        "middle_name": "E",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2011-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5003904",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "PA",
            "license": "SP008030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Reading, PA

Sources for this page

Verify at the official NPI Registry.