Kimberly M Rencken, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

257 Issued in SC

Practice address

107 Church St
Walterboro, SC 29488-2901

Phone

(843) 549-1558

Fax

(843) 549-1454

NPI assigned

Jun 14, 2006

Last updated

Jan 22, 2018By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516579200000",
    "number": "1760425888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 CHURCH ST",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294882901",
            "telephone_number": "843-549-1558",
            "fax_number": "843-549-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 CHURCH ST",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294882901",
            "telephone_number": "843-549-1558",
            "fax_number": "843-549-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENCKEN",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2018-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rapha Family Footcare
• Dee Anne Hickman Reaves, OTR/L
• James Lee Reavis
• Horace Lee Reese III, PHARMD
• Gunther Rencken, MD
• Harold Maurice Rhodes III, D.D.S.
• Rice Planter Pediatrics LLC
• Melanie Richards, DMD
• Rachel Elaine Riley, PT, DPT
• Annette Rivers

• Family Nurse Practitioner in Walterboro, SC
• Providers in Walterboro, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2018; 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.