Su Kim-Hummel

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN11013909 Issued in FL

Practice address

11661 Plantation Preserve Cir S
Fort Myers, FL 33966-8372

Phone

(239) 288-1760

NPI assigned

Jun 9, 2021

Last updated

Aug 16, 2021By 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 2

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": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1790352607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11661 PLANTATION PRESERVE CIR S",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339668372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11661 PLANTATION PRESERVE CIR S",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339668372",
            "telephone_number": "239-288-1760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM-HUMMEL",
        "first_name": "SU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-09",
        "last_updated": "2021-08-16",
        "certification_date": "2021-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11013909",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9362737",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Kilgore
• Iuliana Kiliment, M.D.
• Debra Killackey
• Edward J Killeen, M.D.
• Christine Kilpatrick, PT
• Brian K. Kim, M.D.
• Elizabeth S Kim, CRNA
• Michael Kwangsoo Kim, M.D.
• Min Jee Kim, PHARMD
• Tyler Wayne Kimberlin, LMT

• Nurse Practitioner in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.

Verify at the official NPI Registry.