Individual provider Active NPI

Kimberly Daigneault

  • Family Nurse Practitioner
  • Exeter, NH
National Provider Identifier
1932633971
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
053516-23 Issued in NH
Practice address
21 Hampton Rd BLDG 3
Exeter, NH 03833-4831
Phone
(603) 775-0000
Fax
(603) 778-2491
NPI assigned
Apr 17, 2017
Last updated
Jul 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 053516-23 NH Primary

Addresses

Primary practice location

21 Hampton Rd BLDG 3
Exeter, NH 03833-4831

Mailing address

7 Holland Way FL 1
Exeter, NH 03833-2997
Phone (603) 775-0000

Other identifiers 1

IdentifierTypeStateIssuer
3107956MedicaidNH

Other names 1

  • Kimberly Novicke Former name

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20170614000545 NH Practitioner - Nurse Practitioner 4880962984 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1 Hampton Rd
Unit 107a
Exeter, NH 03833-4849
Phone (603) 580-1749

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
053516-23NHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Life Choice Hospice of New Hampshire, LLC CurrentSince Nov 30, 2022 Accepting new patients
Daigneault Family Care PLLC Family CurrentSince Oct 1, 2021 Accepting new patients

Locations

1 Hampton Rd
Unit 107A
Exeter, NH 03833
Phone (603) 580-1749

1 Hampton Rd
Unit 210
Exeter, NH 03833
Phone (603) 964-5183

10 Cadillac Dr
Ste 400
Brentwood, TN 37027
Phone (615) 637-9163

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24316/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1932633971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 HOLLAND WAY FL 1",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038332997",
            "telephone_number": "603-775-0000",
            "fax_number": "603-778-2491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 HAMPTON RD BLDG 3",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038334831",
            "telephone_number": "603-775-0000",
            "fax_number": "603-778-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAIGNEAULT",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-17",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "053516-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3107956",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "NOVICKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Exeter, NH

Sources for this page

Verify at the official NPI Registry.