Porscha Shantell Kimbro, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

11007402 Issued in FL

Practice address

1043 Town Center Dr
Orange City, FL 32763-8360

Phone

(386) 774-0188

NPI assigned

Jan 29, 2021

Last updated

Jan 29, 2021By the provider in NPPES

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

Enrolled in FL

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Adventist Health System Sunbelt, Inc.Group PAC ID 6406849256, 212 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pkimbro38455@adventhealth.direct-ci.com

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.

• Adventist Health System Sunbelt, Inc.

  dba AdventHealth Centra Care

  • Urgent Care Clinic/Center
  • Maitland, FL
  • NPI 1073565610
  Medicare reassignment Care Compare group NPD
• Florida Hospital Healthcare Partners, Inc

  • Internal Medicine Physician
  • Daytona Beach, FL
  • NPI 1780100529
  Medicare reassignment NPD
• Adventist Health System/ Sunbelt, Inc.

  dba AdventHealth Centra Care - Southern Trace

  • Urgent Care Clinic/Center
  • The Villages, FL
  • NPI 1396605440
  NPD
• Florida Health Care Plan, Inc

  dba FHCP ASC - Orange City

  • Ambulatory Surgical Clinic/Center
  • Orange City, FL
  • NPI 1659759827
  NPD (past)
• Town Center Family Practice Inc

  • Family Medicine Physician
  • Orange City, FL
  • NPI 1669585337
  NPD (past)

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

• Adventist Health System-Sunbelt, Inc

  dba AdventHealth Orlando

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1306938071
  Care Compare affiliation
• Adventist Health System-Sunbelt, Inc

  dba AdventHealth Orlando Outreach Laboratory

  • Clinical Medical Laboratory
  • Orlando, FL
  • NPI 1801569728

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1831780014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 GALAXY ST",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327387216",
            "telephone_number": "407-574-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1043 TOWN CENTER DR",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638360",
            "telephone_number": "386-774-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBRO",
        "first_name": "PORSCHA",
        "middle_name": "SHANTELL",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-29",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11007402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kidd Anesthesia Services, Inc
• Jeffrey Alan Kidd, M.D.
• Kidney Home, LLC
• Kim a. Reddick, DC, LLC (Complete Wellness Center of Orange City)
• Michelle Kimbell, PA-C
• Brandon Kindell
• Hope Arlyne King, ARNP
• Nicole King, MS
• Mark Edward Kleeb, PT, CEAS
• Stephen Senne Knight, MD

• Nurse Practitioner in Orange City, FL
• Providers in Orange City, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.