Kimberly Fordham

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

203684 Issued in TX

Practice address

3307 Spring Stuebner Rd Ste D
Spring, TX 77389-4690

Phone

(346) 800-6001

NPI assigned

Feb 24, 2019

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

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minivasive Pain Specialists,PLLCGroup PAC ID 7113278896, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19285/brand/4/csg/1/fhir/r4

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.

• Minivasive Pain Specialists,PLLC

  • Interventional Pain Medicine Physician
  • Spring, TX
  • NPI 1477099851
  Medicare reassignment Care Compare group NPD
• Houston Kidney Specialists Center PLLC

  • Nephrology Physician
  • Houston, TX
  • NPI 1396217162
  NPD (past)

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

{
    "created_epoch": "1550966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1811454044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 SPRING STUEBNER RD STE 110",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773895195",
            "telephone_number": "346-800-6001",
            "fax_number": "346-800-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3307 SPRING STUEBNER RD STE D",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773894690",
            "telephone_number": "346-800-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORDHAM",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-24",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "203684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Marie Fontenot, M.A., CCC-SLP
• Clorissa A. Fontenot
• Dustin Lane Ford, CRNA
• Joshua William Ford
• Tracy Ford
• Valerie Leonard Foreman
• Forestwood Dental
• Forestwood Sleep Therapy
• Charlotte Yvette Foster-James, RPH, PHARMD
• Ciera Foster

• Family Nurse Practitioner in Spring, TX
• Providers in Spring, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; 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.