Individual provider Active NPI

Kimberly Kay Rathkamp, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Victoria, TX
National Provider Identifier
1811610769
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1095101 Issued in TX
Practice address
506 E San Antonio St
Victoria, TX 77901-6060
Phone
(361) 652-8401
Fax
(361) 788-6655
NPI assigned
Sep 26, 2022
Last updated
Sep 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1095101 TX Primary

Addresses

Primary practice location

506 E San Antonio St
Victoria, TX 77901-6060

Mailing address

110 Laguna Dr
Victoria, TX 77904-3753
Phone (361) 652-8401

Other identifiers 1

IdentifierTypeStateIssuer
1095101OtherTXLICENSE NUMBER

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230118002480 TX Practitioner - Nurse Practitioner 4486025004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Victoria Hospitalist Associates, LLCGroup PAC ID 6204927122, 39 clinicians

Practice addresses (Care Compare)

506 E San Antonio St
De Tar Navarro Hospital
Victoria, TX 77901-6060
Phone (361) 575-7441

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1095101TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Victoria Hospitalist Associates, LLC CurrentSince Dec 5, 2022 Accepting new patients

Locations

506 E San Antonio St
Victoria, TX 77901
Phone (361) 575-1445

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1811610769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LAGUNA DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779043753",
            "telephone_number": "361-652-8401",
            "fax_number": "361-788-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 E SAN ANTONIO ST",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779016060",
            "telephone_number": "361-652-8401",
            "fax_number": "361-788-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATHKAMP",
        "first_name": "KIMBERLY",
        "middle_name": "KAY",
        "credential": "AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-26",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1095101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "1095101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

Verify at the official NPI Registry.