Individual provider Active NPI

Kimberly Beth Stolp, LPN

  • Licensed Practical Nurse
  • Gainesville, GA
National Provider Identifier
1790808673
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN065084 Issued in GA
Practice address
1280 Athens St
Gainesville, GA 30507-7000
Phone
(770) 535-5743
NPI assigned
Apr 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN065084 GA Primary

Addresses

Primary practice location

1280 Athens St
Gainesville, GA 30507-7000

Mailing address

445 Skyland Dr
P.O. Box 1341
Cornelia, GA 30531-4345
Phone (706) 776-2676

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

LicenseStateTypeSpecialty
LPN065084GAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1175904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790808673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 SKYLAND DR",
            "address_2": "P.O. BOX 1341",
            "city": "CORNELIA",
            "state": "GA",
            "postal_code": "305314345",
            "telephone_number": "706-776-2676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 ATHENS ST",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305077000",
            "telephone_number": "770-535-5743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLP",
        "first_name": "KIMBERLY",
        "middle_name": "BETH",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN065084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.