Kimberly Noelle Hanley, APRN, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

110373 Issued in OK

Practice address

4411 W Gore Blvd Ste a
Lawton, OK 73505-6016

Phone

(580) 699-8383

Fax

(580) 699-8381

NPI assigned

Jul 8, 2020

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

Electronic endpoints 1

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.

• Red River Medical Services LLC

  • Pain Medicine Physician
  • Lawton, OK
  • NPI 1558981472

  OK

  Medicare reassignment Care Compare group NPD
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)
• Southwestern Medical Center, LLC

  • General Acute Care Hospital
  • Lawton, OK
  • NPI 1952359986
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)
• University of Oklahoma Health Scien Ctr Southwest Ok Family Practice

  • Family Medicine Physician
  • Lawton, OK
  • NPI 1790893097
  NPD (past)

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

• Comanche County Hospital Authority

  • Land Ambulance
  • Walters, OK
  • NPI 1285181610

  Hospital

  Care Compare affiliation
• Comanche County Hospital Authority

  • General Acute Care Hospital
  • Lawton, OK
  • NPI 1720022379

  Hospital

  Care Compare affiliation
• Comanche County Hospital Authority

  • Land Ambulance
  • Lawton, OK
  • NPI 1770525883

  Hospital

  Care Compare affiliation

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Red River Medical Services LLC 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Health Hospital, Lawton, OK, CCN 370056
• Southwestern Medical Center Hospital, Lawton, OK, CCN 370097

Medicare fee-for-service enrollment

Enrolled in OK

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1801414628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 W GORE BLVD STE A",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056016",
            "telephone_number": "580-699-8383",
            "fax_number": "580-699-8381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 W GORE BLVD STE A",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056016",
            "telephone_number": "580-699-8383",
            "fax_number": "580-699-8381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANLEY",
        "first_name": "KIMBERLY",
        "middle_name": "NOELLE",
        "credential": "APRN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-08",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "110373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Lawton",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Lawton",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Lawton",
            "address_1": "4411 W Gore Blvd Ste A",
            "city": "Lawton",
            "state": "OK",
            "country_code": "US",
            "postal_code": "735056016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jonea Monique Hammond, LPC
• Wendell Scott Hammonds, MS, LADC/MH
• Shalome Saida Hancox-Palomo, LCSW
• Samantha Handy, BHCM II
• David Allen Hanley, MD
• Roger D Hanley, CRNA
• Sameh W Hanna, M.D.
• Traci Hanna
• Amy Hannington, PA
• Elijah Hansen

• All providers in Lawton, OK
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; 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.