Kimberly A Berthold, RN, BC, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2008001025 Issued in MO

Practice address

20 NE Saint Lukes Blvd
Suite 240
Lees Summit, MO 64086-6001

Phone

(816) 931-1883

Fax

(816) 756-3645

NPI assigned

Mar 9, 2009

Last updated

May 8, 2012By 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

Other identifiers 5

Other names 1

• Kimberly A. Gross Former name

Medicare fee-for-service enrollment

Enrolled in MO, KS2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Hospital of Kansas City Hospital, Kansas City, MO, CCN 260138

Merit-based Incentive Payment System (MIPS)

Final score

82.56 of 100Reported as group

Quality

76.07

Promoting interoperability

100

Improvement activities

40

Cost

65.79

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kberthold7762@direct.saint-lukes.org

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.

• Saint Luke's Physician Group Inc

  dba Saint Luke's Medical Group

  • Family Medicine Physician
  • Kansas City, MO
  • NPI 1093263717

  KS

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Lukes Hospital of Kansas City

  dba Saint Luke's Hospital of Kansas City

  • General Acute Care Hospital
  • Kansas City, MO
  • NPI 1063494177
  Care Compare affiliation
• St Lukes Hospital of Kansas City

  dba Crittenton Children's Center

  • General Acute Care Hospital
  • Kansas City, MO
  • NPI 1932642972
  Care Compare affiliation
• St. Luke's Hospital of Kansas City

  dba Saint Luke's Hospital Infusion Center at Liberty

  • General Acute Care Hospital
  • Liberty, MO
  • NPI 1275926198
  Care Compare affiliation

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

{
    "created_epoch": "1236556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336435200000",
    "number": "1780825570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 WORNALL RD",
            "address_2": "SUITE 2000",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641115939",
            "telephone_number": "816-931-1883",
            "fax_number": "816-756-3645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 NE SAINT LUKES BLVD",
            "address_2": "SUITE 240",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640866001",
            "telephone_number": "816-931-1883",
            "fax_number": "816-756-3645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTHOLD",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "RN, BC, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-09",
        "last_updated": "2012-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2008001025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200258340D",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200258340E",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00836071",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00842733",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780825570",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "GROSS",
            "middle_name": "A.",
            "credential": "RN, BC, FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Andrew Berg, PA-C
• Jamie Bergland, PHARMD
• Teresa R Bergman, RN
• Nicole Leigh Bergsten, PT
• Stefanie C Berry, DPT
• Allison Hayden Bertken, DNP
• Elizabeth Bertschy, NP
• Stephanie Marie Betsworth, APRN-C
• Sonal Veeral Bhoot, DMD
• Lucas W Bider, MD

• Family Nurse Practitioner in Lee's Summit, MO
• Providers in Lee's Summit, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.