Kimberly Kay Fenbert, DNP, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

4704137456 Issued in MI

Practice address

684 Harvey St
Ste 201
Muskegon, MI 49442-4274

Phone

(231) 773-7837

Fax

(231) 773-7943

NPI assigned

Jul 9, 2005

Last updated

Feb 26, 2011By the provider in NPPES

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

Other identifiers 1

Other names 1

• Mrs. Kimberly Kay Bleich Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

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.

• Shoreline Pediatrics PLC

  • Pediatrics Physician
  • Muskegon, MI
  • NPI 1609874643
  NPD (past)

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

{
    "created_epoch": "1120867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298678400000",
    "number": "1811995228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "684 HARVEY ST",
            "address_2": "STE 201",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494424274",
            "telephone_number": "231-773-7837",
            "fax_number": "231-773-7943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "684 HARVEY ST",
            "address_2": "STE 201",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494424274",
            "telephone_number": "231-773-7837",
            "fax_number": "231-773-7943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENBERT",
        "first_name": "KIMBERLY",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "DNP, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-09",
        "last_updated": "2011-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704137456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4485859",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "BLEICH",
            "middle_name": "KAY",
            "prefix": "MRS.",
            "credential": "CPNP - RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Yameenah Farrukh, MD
• Sara Farwig
• Christine R Faser, MD
• Charles E Feldt, DO
• Julie Jeanette Felt, MD,MMM
• Kimberly Anne Ferguson
• Branda Ferrier
• Paul Fessenden
• Daniel J Fett, D.O.
• Carolyn Feuerstein

• Pediatric Nurse Practitioner in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Pediatric Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.