Individual provider Active NPI

Kimberly Avant Rao, FNP

  • Family Nurse Practitioner
  • Alexandria, LA
National Provider Identifier
1811203318
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP06212 Issued in LA
Practice address
211 N 3Rd St Ste a
Alexandria, LA 71301-8568
Phone
(318) 625-7299
Fax
(318) 625-7169
NPI assigned
Aug 23, 2010
Last updated
Jun 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP06212 LA Primary

Addresses

Primary practice location

211 N 3Rd St Ste a
Alexandria, LA 71301-8568

Mailing address

211 N 3Rd St Ste a
Alexandria, LA 71301-8568
Phone (186) 257-2993

Other identifiers 1

IdentifierTypeStateIssuer
2195565MedicaidLA

Other names 1

  • Ms. Kimberly Fitzpatrick Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20110215000609 LA Practitioner - Nurse Practitioner 9436339942 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1411 Peterman Dr
Alexandria, LA 71301-3433
Phone (318) 704-2900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Health Central Louisiana CurrentSince Sep 1, 2018 Accepting new patients
Cenla Family Medicine Associates, LLC CurrentSince Aug 1, 2019 Accepting new patients
Christus Health Central Louisiana CurrentSince Sep 1, 2018 Accepting new patients
Neuromedical Clinic of Cenla,L.L.C. CurrentSince Jan 3, 2011 Accepting new patients

Locations

1587 N Bolton Ave
Ste 1100
Alexandria, LA 71303
Phone (318) 445-9823

3311 Prescott Rd
Ste 216
Alexandria, LA 71301
Phone (318) 443-0490

3330 Masonic Dr
Alexandria, LA 71301
Phone (318) 448-6917

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • FHIR API: https://fhir4.healow.com/fhir/r4/AHGBCD/Endpoint/AHGBCD
  • FHIR API: https://fhir4.healow.com/fhir/r4/CEDCAA

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1282521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1811203318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N 3RD ST STE A",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713018568",
            "telephone_number": "186-257-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N 3RD ST STE A",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713018568",
            "telephone_number": "318-625-7299",
            "fax_number": "318-625-7169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAO",
        "first_name": "KIMBERLY",
        "middle_name": "AVANT",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-23",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP06212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2195565",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "FITZPATRICK",
            "prefix": "MS.",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alexandria, LA

Sources for this page

Verify at the official NPI Registry.