Active NPI
Kimberly McIltrot, C.R.N.P.
- Nurse Practitioner
- Baltimore, MD
National Provider Identifier
1922057066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- R115446
- Practice address
- 600 N Wolfe St
Baltimore, MD 21287-0005 - Phone
- (410) 955-9444
- NPI assigned
- May 8, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Wound Care Registered Nurse | 163WW0000X | ARNP9453359 | FL | |
| Nurse Practitioner | 363L00000X | R115446 | MD | Primary |
Addresses
Primary practice location
600 N Wolfe St
Baltimore, MD 21287-0005
Mailing address
PO Box 64563
Baltimore, MD 21264-4563
Phone (410) 933-7440
Other practice location 1
601 5th St S Ste 306
St Petersburg, FL 33701-4804
Phone (727) 767-4170
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020717600 | Medicaid | FL | |
| 403693000 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Interoperability endpoints
- kmciltrot38117@direct.kennedykrieger.org
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1922057066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 64563",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212644563",
"telephone_number": "410-933-7440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 N WOLFE ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212870005",
"telephone_number": "410-955-9444"
}
],
"practiceLocations": [
{
"address_1": "601 5th St S Ste 306",
"address_purpose": "LOCATION",
"city": "St Petersburg",
"state": "FL",
"postal_code": "337014804",
"country_code": "US",
"telephone_number": "727-767-4170",
"fax_number": "727-767-4346",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCILTROT",
"first_name": "KIMBERLY",
"credential": "C.R.N.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-08",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "163WW0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Wound Care",
"state": "FL",
"license": "ARNP9453359",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MD",
"license": "R115446",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "020717600",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "403693000",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.