Kimberly Renae Mullins, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024170685 Issued in VA

Practice address

121 Advanced Technology Drive
Duffield, VA 24244

Phone

(276) 431-2648

Fax

(276) 431-2082

NPI assigned

Apr 23, 2013

Last updated

Oct 19, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Kimberly Muprhy Other name

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Holston Medical Group PCGroup PAC ID 8224935754, 239 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lonesome Pine Hospital Hospital, Big Stone Gap, VA, CCN 490114
• Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kimberlymullins@hmgpath.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Holston Medical Group PC

  • Family Medicine Physician
  • Kingsport, TN
  • NPI 1831110667

  VA

  Medicare reassignment Care Compare group NPD

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

• Wellmont Health System

  dba Lonesome Pine Hospital

  • General Acute Care Hospital
  • Big Stone Gap, VA
  • NPI 1801826912
  Care Compare affiliation
• Wellmont Health System

  dba Holston Valley Medical Center

  • General Acute Care Hospital
  • Kingsport, TN
  • NPI 1487690400
  Care Compare affiliation

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

{
    "created_epoch": "1366675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508371200000",
    "number": "1750725636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376620009",
            "telephone_number": "423-857-2066",
            "fax_number": "423-857-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 ADVANCED TECHNOLOGY DRIVE",
            "city": "DUFFIELD",
            "state": "VA",
            "postal_code": "24244",
            "telephone_number": "276-431-2648",
            "fax_number": "276-431-2082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "KIMBERLY",
        "middle_name": "RENAE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-23",
        "last_updated": "2017-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024170685",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0017140919",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "VA",
            "license": "0001201805",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q004515",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "MUPRHY",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Stephanie Rose Miller, RPT
• Kimberly Mills, OTR/L
• MMDS International LLC
• MMDS of Kingsport LLC
• Mountain Region Personal Care Services Inc.
• Richard S Nicholas, PHARMD, ND
• Jada Jocelyn Oakes, BSN
• Elizabeth Palabrica
• Zeni Matilda Gibson Peak
• Shonna Peterson, RN

• Family Nurse Practitioner in Duffield, VA
• Providers in Duffield, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.