Individual provider Active NPI

Kimberly D McIntyre, ACNS-BC

  • Adult Health Clinical Nurse Specialist
  • Kettering, OH
National Provider Identifier
1871921759
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
APRN.CNS.15141 Issued in OH
Practice address
3737 Southern Blvd Ste 2100
Kettering, OH 45429-1285
Phone
(937) 433-5309
NPI assigned
Oct 31, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X APRN11013591 FL
Adult Health Clinical Nurse Specialist 364SA2200X APRN.CNS.15141 OH Primary

Addresses

Primary practice location

3737 Southern Blvd Ste 2100
Kettering, OH 45429-1285

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-6063

Other practice location 1

801 E 6th St Ste 606
Panama City, FL 32401-3645
Phone (850) 913-6960

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kmcintyre551126@direct.ketteringhealth.org
FHIR URL https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150318002651 OH Practitioner - Certified Clinical Nurse Specialist (CNS) 0749507325 Reassigns benefits to 1 organization
I20210920002965 FL Practitioner - Nurse Practitioner 0749507325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

3737 Southern Blvd
Suite 2100
Kettering, OH 45429-1285
Phone (937) 558-3214

Hospital & facility affiliations

  • Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
  • Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
  • Soin Medical Center Hospital, Beaver Creek, OH, CCN 360360
  • Kettering Health Miamisburg Hospital, Miamisburg, OH, CCN 360239

Merit-based Incentive Payment System (MIPS)

Final score
81.34 of 100Reported as group
Quality
63.67
Promoting interoperability
100
Improvement activities
40
Cost
74.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11013591FLMDAdult Health Clinical Nurse Specialist
APRN.CNS.15141OHMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. Current Accepting new patients
Sacred Heart Health System Inc CurrentSince Sep 1, 2021 Accepting new patients
Kettering Independent Medical Group Inc CurrentSince Feb 19, 2024 Accepting new patients
Sacred Heart Health System, Inc. CurrentSince Sep 1, 2021 Accepting new patients

Locations

36500 Emerald Coast Pkwy
Destin, FL 32541
Phone (850) 269-0301

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

801 E 6th St
Ste 606
Panama City, FL 32401
Phone (850) 785-2229

801 E 6th St
Panama City, FL 32401
Phone (850) 747-6018

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

3737 Southern Blvd
Ste 2100
Kettering, OH 45429
Phone (937) 294-1632

3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221

4000 Miamisburg Centerville Rd
Ste 435
Miamisburg, OH 45342
Phone (937) 384-4511

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

4000 Miamisburg Centerville Rd
Ste 420
Miamisburg, OH 45342
Phone (937) 384-4511

113 W National Rd
Vandalia, OH 45377
Phone (937) 223-6837

Interoperability endpoints

  • Direct secure messaging: kimberly.mcintyre.1@9582.direct.athenahealth.com
  • Direct secure messaging: kimberly.mcintyre@2498.securemail.prognocis.com

Organizations & group practices 4

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 4

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": "1383177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1871921759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6063",
            "fax_number": "904-539-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 SOUTHERN BLVD STE 2100",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291285",
            "telephone_number": "937-433-5309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 E 6th St Ste 606",
            "address_purpose": "LOCATION",
            "city": "Panama City",
            "state": "FL",
            "postal_code": "324013645",
            "country_code": "US",
            "telephone_number": "850-913-6960",
            "fax_number": "850-608-6434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "KIMBERLY",
        "middle_name": "D",
        "credential": "ACNS-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-31",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "FL",
            "license": "APRN11013591",
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "OH",
            "license": "APRN.CNS.15141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmcintyre551126@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "4000 Miamisburg Centerville Rd Ste 420",
            "city": "Miamisburg",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453427615",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "3737 Southern Blvd Ste 2100",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.