Kimberly C Stephens, MSN APRN FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP9362511 Issued in FL

Practice address

865 Blanding Blvd
Orange Park, FL 32065-8917

Phone

(904) 276-1133

Fax

(904) 276-1821

NPI assigned

Jun 29, 2018

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

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

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.

• Clay Primary & Family Care LLC

  • Family Medicine Physician
  • Orange Park, FL
  • NPI 1730186792
  Medicare reassignment NPD

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

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1902391139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 BLANDING BLVD",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320658917",
            "telephone_number": "904-276-1133",
            "fax_number": "904-276-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 BLANDING BLVD",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320658917",
            "telephone_number": "904-276-1133",
            "fax_number": "904-276-1821"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7307 N Main St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322084123",
            "country_code": "US",
            "telephone_number": "904-374-3311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "KIMBERLY",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "MSN APRN FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-29",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9362511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Anthony Stawara, MD
• Kristin Danielle Steacy
• Andy Stephan Steczo, CRNA
• Sarah Elizabeth Steeg, OTR/L
• Ursula Stein, LCSW
• Kimberlyn D Stephens
• Lauren Stephens, PA
• Michael Anthony Stephens, MD
• Ronny W Stephens, LMHC,CAP
• Sarah Ilene Stephens, PHARM.D.

• Family Nurse Practitioner in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.