Individual provider Active NPI

Kimberly Patrick, NP-C

  • Nurse Practitioner
  • Auburn, AL
National Provider Identifier
1801362579
Registry record updated Oct 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-122381 Issued in AL
Practice address
1518 Professional Pkwy Ste a
Auburn, AL 36830-2857
Phone
(334) 321-0060
NPI assigned
Oct 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-122381 AL Primary

Addresses

Primary practice location

1518 Professional Pkwy Ste a
Auburn, AL 36830-2857

Mailing address

1518 Professional Pkwy Ste a
Auburn, AL 36830-2857

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20201016000164 AL Practitioner - Nurse Practitioner 9931529724 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
1-122381ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC Nurse Practitioner CurrentSince Jan 1, 2022 Accepting new patients
Greater Montgomery Patient Centered Gastroenterology and Hepatology Past Accepting new patients

Locations

4000 Eagle Point Corporate Dr
Birmingham, AL 35242
Phone (205) 317-0280

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1539907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540080000000",
    "number": "1801362579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1518 PROFESSIONAL PKWY STE A",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368302857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1518 PROFESSIONAL PKWY STE A",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368302857",
            "telephone_number": "334-321-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "KIMBERLY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-19",
        "last_updated": "2018-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-122381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, AL

Sources for this page

Verify at the official NPI Registry.