Amy Rachel Kimble

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN5182511 Issued in FL

Practice address

651 W Warren Ave Ste 100
Longwood, FL 32750-4036

Phone

(877) 276-4982

NPI assigned

Jun 14, 2023

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1780368258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 W WARREN AVE STE 100",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504036",
            "telephone_number": "877-276-4982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 W WARREN AVE STE 100",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504036",
            "telephone_number": "877-276-4982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBLE",
        "first_name": "AMY",
        "middle_name": "RACHEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5182511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kids Connection Therapy LLC
• Kids Connection Therapy LLC
• Kids Plus Services Inc
• Bumsoo Kim, PTA
• Kimberly Watson, D.C., P.a.
• Alyssa Katelyn King
• Lakendra Daniele King, LCSW
• Melissa Lynne King, PH.D., BCBA-D
• Patricia King
• Richelle Marissa King

• Licensed Practical Nurse in Longwood, FL
• Providers in Longwood, FL by specialty
• Licensed Practical Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.