NPIMap

Individual provider Active NPI

Kimberly M Myers, FNP

  • Family Nurse Practitioner
  • Addison, TX
National Provider Identifier
1821119116
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
572642 Issued in TX
Practice address
17051 Dallas Pkwy Ste 400
Addison, TX 75001-7108
Phone
(214) 370-3535
NPI assigned
Apr 3, 2007
Last updated
Jun 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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 572642 TX Primary

Addresses

Primary practice location

17051 Dallas Pkwy Ste 400
Addison, TX 75001-7108

Mailing address

17051 Dallas Pkwy Ste 400
Addison, TX 75001-7108
Phone (214) 370-3535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050222000400 TX Practitioner - Nurse Practitioner 0244283091 Reassigns benefits to 2 organizations
Practice locations: Celina, TX

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Spine Consultants, LLPGroup PAC ID 5890850804, 14 clinicians
Green Oaks Physical Therapy Limited PartnershipGroup PAC ID 4688582141, shared by 2 NPIs, 208 clinicians

Practice addresses (Care Compare)

17051 Dallas Pkwy
Suite 400
Addison, TX 75001-7108
Phone (214) 370-3535

2000 FM
663 Suite 160
Midlothian, TX 76065-6559
Phone (469) 856-2476

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
572642TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Spine Consultants, LLP CurrentSince Dec 3, 2018 Accepting new patients
Texas Spine Consultants, LLP CurrentSince Dec 3, 2018 Accepting new patients
Modera Clinic PLLC CurrentSince Sep 30, 2023 Accepting new patients
Pilot Point Family Practice Management Inc. Past Accepting new patients
Pilot Point Medical Clinic, P.a. Past Accepting new patients

Locations

17051 Dallas Pkwy
Ste 400
Addison, TX 75001
Phone (469) 243-9390

4461 Coit Rd
Ste 101
Frisco, TX 75035
Phone (844) 557-4263

2700 E Eldorado Pkwy
Ste 104B
Little Elm, TX 75068
Phone (972) 987-0458

Interoperability endpoints

  • Direct secure messaging: kimberly.myers.1@15749.direct.athenahealth.com

Organizations & group practices 5

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 6

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1821119116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17051 DALLAS PKWY STE 400",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750017108",
            "telephone_number": "214-370-3535",
            "fax_number": "214-370-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17051 DALLAS PKWY STE 400",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750017108",
            "telephone_number": "214-370-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "572642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Addison, TX

Sources for this page

Verify at the official NPI Registry.