Kimberly Blue

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PA316486 Issued in PA

Practice address

4209 Robbins Ave
Philadelphia, PA 19135-3114

Phone

(267) 402-0713

NPI assigned

Apr 28, 2022

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1651104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1821733494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4209 ROBBINS AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191353114",
            "telephone_number": "267-402-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4209 ROBBINS AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191353114",
            "telephone_number": "267-402-0713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUE",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-28",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "PA",
            "license": "PA316486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Peak Group Supply Inc
• Blue Ridge Home Care, Inc
• Blue Skies Chiropractic, PC
• Blue Tiger Home Healthcare
• Ciara Blue-Thompson
• Rachel Blue, MD
• Shawn Lynette Blue, PSY.D.
• Blueford Charter School
• Bethany Blum, DO
• Carol Ann Blum, M.ED., CAC, LPC

• Licensed Practical Nurse in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Licensed Practical Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; 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.