Individual provider Active NPI

Kimberly A Dare, FNP, BC

  • Family Nurse Practitioner
  • Fuquay Varina, NC
National Provider Identifier
1750892949
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
501902 Issued in NC
Practice address
605 N Main St
Fuquay Varina, NC 27526-2026
Phone
(954) 234-8049
NPI assigned
Oct 16, 2017
Last updated
Jun 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3075012 FL
Family Nurse Practitioner 363LF0000X 501902 NC Primary
Critical Care Medicine Registered Nurse 163WC0200X 3075012 FL

Addresses

Primary practice location

605 N Main St
Fuquay Varina, NC 27526-2026

Mailing address

201 Parker Station Ave
Fuquay Varina, NC 27526-1995
Phone (954) 234-8049

Other practice location 1

201 Parker Station Ave
Fuquay Varina, NC 27526-1995
Phone (954) 234-8049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20190509000427 NC Practitioner - Nurse Practitioner 2163776295 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of North Carolina PCGroup PAC ID 6002837572, 208 clinicians
Minuteclinic Primary Care North Carolina PLLCGroup PAC ID 9234657545, 9 clinicians

Practice addresses (Care Compare)

605 N Main St
Fuquay Varina, NC 27526-2026
Phone (866) 389-2727

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3075012FLMDFamily Nurse Practitioner
501902NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Primary Care North Carolina PLLC Family CurrentSince Jul 23, 2025 Accepting new patients
Minuteclinic Diagnostic of North Carolina PC Family CurrentSince Jul 23, 2025 Accepting new patients

Locations

10100 S Main St
Archdale, NC 27263
Phone (336) 431-0715

605 N Main St
Fuquay Varina, NC 27526
Phone (919) 552-8299

6840 Glenwood Ave
Raleigh, NC 27612
Phone (401) 770-4415

1 Cvs Dr
#2295
Woonsocket, RI 02895
Phone (401) 770-8043

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: kimberly.dare@59342936014852.direct.elationemr.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1508112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1750892949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARKER STATION AVE",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275261995",
            "telephone_number": "954-234-8049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 N MAIN ST",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262026",
            "telephone_number": "954-234-8049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Parker Station Ave",
            "address_purpose": "LOCATION",
            "city": "Fuquay Varina",
            "state": "NC",
            "postal_code": "275261995",
            "country_code": "US",
            "telephone_number": "954-234-8049",
            "fax_number": "954-941-4600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DARE",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "FNP, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-16",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "3075012",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "501902",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "FL",
            "license": "3075012",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fuquay Varina, NC

Sources for this page

Verify at the official NPI Registry.