Individual provider Active NPI

Kimberly Carpenter, CRNA

  • Certified Registered Nurse Anesthetist
  • Montgomery, AL
National Provider Identifier
1891184503
Registry record updated Jan 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
104564 Issued in AL
Practice address
1725 Pine St
Montgomery, AL 36106-1109
Phone
(850) 261-1262
NPI assigned
Jan 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1-135150 AL
Certified Registered Nurse Anesthetist 367500000X 104564 AL Primary

Addresses

Primary practice location

1725 Pine St
Montgomery, AL 36106-1109

Mailing address

2483 Vera Cruz Dr
Birmingham, AL 35235-2234
Phone (850) 261-1262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150406002363 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7618295593 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Anesthesia of Montgomery PCGroup PAC ID 5799684148, 117 clinicians

Practice addresses (Care Compare)

2105 E S Blvd
Montgomery, AL 36116-2409
Phone (334) 286-3579

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
104564ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Montgomery Anesthesia Associates, PC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2015 Accepting new patients
Premier Anesthesia of Montgomery PC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2023 Accepting new patients

Locations

1725 Pine St
Montgomery, AL 36106
Phone (334) 293-8000

2105 E South Blvd
Montgomery, AL 36116
Phone (334) 286-2842

Organizations & group practices 2

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": "1421625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421625600000",
    "number": "1891184503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2483 VERA CRUZ DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352352234",
            "telephone_number": "850-261-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 PINE ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061109",
            "telephone_number": "850-261-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "KIMBERLY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-19",
        "last_updated": "2015-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-135150",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "104564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.