Kimberly Grace Anderson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

123169 Issued in AR

Practice address

1501 Aldersgate Rd
Little Rock, AR 72205-6611

Phone

(501) 666-7526

Fax

(501) 660-7876

NPI assigned

Jun 7, 2023

Last updated

Feb 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Grace Mirabal Former name

Medicare fee-for-service enrollment

Enrolled in AR

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elite Medical Group LLCGroup PAC ID 0840708897, 2 clinicians

Wound Logix LLCGroup PAC ID 2264968270, 4 clinicians

Appello Health and Wellness Clinic LLCGroup PAC ID 3971043290, 76 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Stat Home Health - Cenark, LLC Home health agency, Little Rock, AR, CCN 047117

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kimberly.anderson.1@30469.direct.athenahealth.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.

• Elite Medical Group LLC

  • Family Medicine Physician
  • Searcy, AR
  • NPI 1710701586
  Medicare reassignment Care Compare group NPD
• Wound Logix LLC

  • Wound Care Registered Nurse
  • Searcy, AR
  • NPI 1063236750
  Medicare reassignment Care Compare group NPD
• Appello Health and Wellness Clinic, LLC

  • Rural Health Clinic/Center
  • Malvern, AR
  • NPI 1215773262
  Medicare reassignment Care Compare group
• Virtual Medical Solutions, LLC

  dba Carter County Wound Care

  • Medical Specialty Clinic/Center
  • Ardmore, OK
  • NPI 1801538467

  AR

  Medicare reassignment NPD
• Access Health Family and Urgent Care, LLC

  • Primary Care Clinic/Center
  • Ardmore, OK
  • NPI 1275403958
  NPD (past)

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

• Stat Home Health - Cenark LLC

  • Home Health Agency
  • Little Rock, AR
  • NPI 1912464009
  Care Compare affiliation

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

{
    "created_epoch": "1686096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1851085203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 BLUEBIRD LN",
            "city": "DES ARC",
            "state": "AR",
            "postal_code": "720403496",
            "telephone_number": "501-388-2150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 ALDERSGATE RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056611",
            "telephone_number": "501-666-7526",
            "fax_number": "501-660-7876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KIMBERLY",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-07",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "123169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "MIRABAL",
            "middle_name": "GRACE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Anderson, MD
• Jennifer Lynn Anderson, MD
• Jocelyn C Anderson
• John R Anderson, PH.D.
• Katlynn Anderson
• Lindsey A Anderson, AU.D.
• Lynda Jean Anderson, M.S., R.D., L.D.
• Maria Renae Anderson, PA-C
• Marlee Anderson, PT, DPT
• Maureen Anderson, CNA

• Family Nurse Practitioner in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; 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.