Active NPI
Kimberly Ann Payne, NPC
- Nurse Practitioner
- Paoli, PA
National Provider Identifier
1952418006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- SP009021
- Practice address
- 255 W Lancaster Ave
Paoli, PA 19301-1763 - Phone
- (484) 565-8162
- NPI assigned
- Aug 24, 2006
- Last updated
- Jul 28, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | SP009021 | PA | Primary |
Addresses
Primary practice location
255 W Lancaster Ave
Paoli, PA 19301-1763
Mailing address
255 W Lancaster Ave
Paoli, PA 19301-1763
Phone (484) 565-8162
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201218000005 | PA | Order and Referring Only - Nurse Practitioner | 5294731055 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP009021 | PA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469664000000",
"number": "1952418006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 W LANCASTER AVE",
"city": "PAOLI",
"state": "PA",
"postal_code": "193011763",
"telephone_number": "484-565-8162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 W LANCASTER AVE",
"city": "PAOLI",
"state": "PA",
"postal_code": "193011763",
"telephone_number": "484-565-8162"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAYNE",
"first_name": "KIMBERLY",
"middle_name": "ANN",
"credential": "NPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-24",
"last_updated": "2016-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "PA",
"license": "SP009021",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Paoli, PA
- Debbie Parnes, D.M.D.
- Darshan Rajendra Patel, M.D.
- Nirav S. Patel, D.C.
- William Leonard Patton
- Mitchell H Paulin, MD
- Mark William Pearson, DC
- Pediatric Associates of Paoli, PC (Pediatric Associates of Paoli)
- Pediatric Eye Physicians & Surgeons PC
- Sandra Ellen Pellatt, DNP, CRNP
- Ann Marie Pellegrino, CRNP APRNC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; 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.