Individual provider Active NPI

Kimberly P Reedy, RN

  • Nutrition Support Registered Nurse
  • Phoenix, AZ
National Provider Identifier
1942144027
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition Support Registered NurseTaxonomy code 163WN1003X
License
177806 Issued in AZ
Practice address
3938 W Laurel LN
Phoenix, AZ 85029-3030
Phone
(602) 561-8491
NPI assigned
Apr 17, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Support Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WN1003X 177806 AZ Primary

Addresses

Primary practice location

3938 W Laurel LN
Phoenix, AZ 85029-3030

Mailing address

3938 W Laurel LN
Phoenix, AZ 85029-3030

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
177806AZMDNutrition Support Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1776384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1942144027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3938 W LAUREL LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850293030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3938 W LAUREL LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850293030",
            "telephone_number": "602-561-8491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEDY",
        "first_name": "KIMBERLY",
        "middle_name": "P",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-17",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN1003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Nutrition Support",
            "state": "AZ",
            "license": "177806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.