Active NPI
Kimberly Pugh, APRN/FNP-C
- Family Nurse Practitioner
- Plant City, FL
National Provider Identifier
1770173767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 11011231
- Practice address
- 3601 Stanley Rd
Plant City, FL 33565-4865 - Phone
- (813) 451-6710
- NPI assigned
- Jan 22, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 11011231 | FL | Primary |
Addresses
Primary practice location
3601 Stanley Rd
Plant City, FL 33565-4865
Mailing address
3601 Stanley Rd
Plant City, FL 33565-4865
Phone (813) 451-6710
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11011231 | FL | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611273600000",
"number": "1770173767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3601 STANLEY RD",
"city": "PLANT CITY",
"state": "FL",
"postal_code": "335654865",
"telephone_number": "813-451-6710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 STANLEY RD",
"city": "PLANT CITY",
"state": "FL",
"postal_code": "335654865",
"telephone_number": "813-451-6710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUGH",
"first_name": "KIMBERLY",
"credential": "APRN/FNP-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-22",
"last_updated": "2021-01-22",
"certification_date": "2021-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "11011231",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plant City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.