Kimberly Denise Souza, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2014035648 Issued in MO

Practice address

400 E Court Ave Ste 110
Des Moines, IA 50309-2027

Phone

(860) 788-6404

NPI assigned

Oct 9, 2014

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO, IA, VA, KS, CO5 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 5

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Meditelecare of Iowa PLLCGroup PAC ID 0446512503, 5 clinicians

Meditelecare of Missouri LLCGroup PAC ID 2961764584, 6 clinicians

Meditelecare of Virginia LLCGroup PAC ID 2163785973, 5 clinicians

Meditelecare of Kansas LLCGroup PAC ID 5294097549, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Highlands Nursing home, Decorah, IA, CCN 165178

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Meditelecare of Iowa PLLC

  • Psychologist
  • Des Moines, IA
  • NPI 1386146678
  Medicare reassignment Care Compare group NPD
• Meditelecare of Kansas LLC

  • Psychologist
  • Topeka, KS
  • NPI 1083116628
  Medicare reassignment Care Compare group NPD
• Meditelecare of Missouri LLC

  • Clinical Psychologist
  • Saint Louis, MO
  • NPI 1013416585
  Medicare reassignment Care Compare group NPD
• Meditelecare of Virginia, LLC

  • Clinical Psychologist
  • Glen Allen, VA
  • NPI 1851890321
  Medicare reassignment Care Compare group NPD
• Meditelecare of Colorado LLC

  • Clinical Psychologist
  • Littleton, CO
  • NPI 1407471774
  Medicare reassignment NPD
• Alpha Healthcare Services and Solutions, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Sterling, VA
  • NPI 1295393791
  Medicare reassignment

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

• Aase Haugen Homes, Inc.

  • Skilled Nursing Facility
  • Decorah, IA
  • NPI 1285638148

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1412812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1902200645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1595",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064578095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E COURT AVE STE 110",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503092027",
            "telephone_number": "860-788-6404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 S Central Ave",
            "address_purpose": "LOCATION",
            "city": "Clayton",
            "state": "MO",
            "postal_code": "631051705",
            "country_code": "US",
            "telephone_number": "860-788-6404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "112 SW 7th St Ste 3C",
            "address_purpose": "LOCATION",
            "city": "Topeka",
            "state": "KS",
            "postal_code": "666033858",
            "country_code": "US",
            "telephone_number": "860-788-6404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4701 Cox Rd Ste 285",
            "address_purpose": "LOCATION",
            "city": "Glen Allen",
            "state": "VA",
            "postal_code": "230606808",
            "country_code": "US",
            "telephone_number": "860-788-6404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOUZA",
        "first_name": "KIMBERLY",
        "middle_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-09",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2014035648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12803160",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER TRANSACTION ACCESS NUMBER",
            "identifier": "MA3251006",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Des Moines Chiropractic
• South Des Moines Dental
• Kristen South, PHARMD
• Jessica Anne Southard, PA
• Southwest Medical Transportation
• Heather L Soyer, PSY.D.
• Leslie Soyer, NNP
• Elizabeth Anne Spain, LPN
• Beverly Christine Sparkman, RRT
• Cindy Sparrow, LMHC

• Family Nurse Practitioner in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Family Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.