Individual provider Active NPI

Kimberly Raichel, ARNP

  • Nurse Practitioner
  • Hazard, KY
National Provider Identifier
1821090283
Registry record updated Jul 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4350P Issued in KY
Practice address
210 Black Gold Blvd
Hazard, KY 41701-2603
Phone
(606) 436-0711
Fax
(606) 436-0848
NPI assigned
Aug 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4350P KY Primary

Addresses

Primary practice location

210 Black Gold Blvd
Hazard, KY 41701-2603

Mailing address

210 Black Gold Blvd
Hazard, KY 41701-2603
Phone (606) 436-0711

Other identifiers 1

IdentifierTypeStateIssuer
78013265MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4350PKYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Appalachian Regional Healthcare, Inc Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185494400000",
    "number": "1821090283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 BLACK GOLD BLVD",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417012603",
            "telephone_number": "606-436-0711",
            "fax_number": "606-436-0848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 BLACK GOLD BLVD",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417012603",
            "telephone_number": "606-436-0711",
            "fax_number": "606-436-0848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAICHEL",
        "first_name": "KIMBERLY",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-15",
        "last_updated": "2007-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4350P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78013265",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazard, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2007; 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.