NPIMap

Individual provider Active NPI

Kimberly Jaudon Kiser, APRN

  • Family Nurse Practitioner
  • Ashland, KY
National Provider Identifier
1841716636
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3011550 Issued in KY
Practice address
613 23Rd St Ste 440
Ashland, KY 41101
Phone
(606) 329-2888
Fax
(606) 329-2890
NPI assigned
Aug 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2019

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 3011550 KY Primary

Addresses

Primary practice location

613 23Rd St Ste 440
Ashland, KY 41101

Mailing address

PO Box 2379
Ashland, KY 41105-2379
Phone (606) 408-6200

Other identifiers 2

IdentifierTypeStateIssuer
7100548840MedicaidKY
0302024MedicaidOH

Other names 1

  • Kimberly Jaudon Short Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20180720002075 KY Practitioner - Nurse Practitioner 8628325669 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

613 23Rd St
Suite 440
Ashland, KY 41101-2885
Phone (606) 329-2888

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.04 of 100Reported as group
Quality
60.55
Promoting interoperability
100
Improvement activities
40
Cost
78.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3011550KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ashland Hospital Corporation CurrentSince Apr 4, 2019 Accepting new patients
Ashland Hospital Corporation Family CurrentSince Apr 4, 2019 Accepting new patients
Kings Daughters Medical Specialties Inc., CurrentSince Jul 23, 2018 Accepting new patients
Kings Daughters Medical Specialties Inc Current Accepting new patients
Ashland Hospital Corporation Current Accepting new patients
Kings Daughters Medical Specialties Inc CurrentSince Jul 23, 2018 Accepting new patients

Locations

613 23rd St
Ste 440
Ashland, KY 41101
Phone (606) 329-2888

2201 Lexington Ave
Ashland, KY 41101
Phone (606) 268-2560

12100 Princeland Spur
Ashland, KY 41102
Phone (606) 928-2963

613 23rd St
Ste 340
Ashland, KY 41101
Phone (606) 326-1101

Interoperability endpoints

  • Direct secure messaging: kshort66904@direct.kdhealth.us

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1502668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1841716636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2379",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411052379",
            "telephone_number": "606-408-6200",
            "fax_number": "606-408-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 23RD ST STE 440",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "41101",
            "telephone_number": "606-329-2888",
            "fax_number": "606-329-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISER",
        "first_name": "KIMBERLY",
        "middle_name": "JAUDON",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-14",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3011550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100548840",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0302024",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "SHORT",
            "middle_name": "JAUDON",
            "credential": "ARPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ashland, KY

Sources for this page

Verify at the official NPI Registry.