Individual provider Active NPI

Kimberly Anne Stump, APRN-FNP-C

  • Family Nurse Practitioner
  • Lima, OH
National Provider Identifier
1770129835
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.025301 Issued in OH
Practice address
512 N Cable Rd
Lima, OH 45805-2133
Phone
(419) 228-2600
NPI assigned
Nov 25, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.025301 OH Primary

Addresses

Primary practice location

512 N Cable Rd
Lima, OH 45805-2133

Mailing address

512 N Cable Rd
Lima, OH 45805-2133
Phone (419) 228-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20220711002161 OH Practitioner - Nurse Practitioner 7012397888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gi Physicians IncGroup PAC ID 9234038845, 5 clinicians

Practice addresses (Care Compare)

512 N Cable Rd
Lima, OH 45805-2133
Phone (419) 228-2600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.025301OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gi Physicians Inc CurrentSince Jun 17, 2022 Accepting new patients
Lima Memorial Joint Operating Company PastSince Jun 17, 2022 Accepting new patients

Locations

1015 S Blackhoof St
Ste B
Wapakoneta, OH 45895
Phone (419) 738-1655

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": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1770129835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 N CABLE RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458052133",
            "telephone_number": "419-228-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 N CABLE RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458052133",
            "telephone_number": "419-228-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUMP",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "credential": "APRN-FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-25",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.025301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.