Kimberly Denise Fedrick, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

062344 Issued in GA

Practice address

300 W Hospital Rd
Augusta, GA 30905-5741

Phone

(706) 787-7471

NPI assigned

Jul 3, 2008

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": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215043200000",
    "number": "1801059589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2503 INVERNESS DR",
            "city": "HEPHZIBAH",
            "state": "GA",
            "postal_code": "308155845",
            "telephone_number": "706-798-4658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W HOSPITAL RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309055741",
            "telephone_number": "706-787-7471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDRICK",
        "first_name": "KIMBERLY",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-03",
        "last_updated": "2008-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "062344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohamad Fawaz, DMD
• Oladapo O Fawibe I, MD
• Herbert Peter Fechter III, MD
• Kimberly Ann Fedele, CRNA
• Meghan Federman
• Kimberly Joan Fee, M.S., LPC
• Angela R Feeser, LPC
• Samantha Nicole Feinstein, MD
• Jack A Feldman, MD
• Madeline Felice, DO

• Licensed Practical Nurse in Augusta, GA
• Providers in Augusta, GA by specialty
• Licensed Practical Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; 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.