Kimberly S Handrock, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

71001322A Issued in IN

Practice address

2705 N Lebanon St Ste 415
Lebanon, IN 46052-8621

Phone

(765) 485-8900

Fax

(765) 485-8909

NPI assigned

Nov 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Kimberly S Roller Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kimberly.handrock.1@20754.direct.athenahealth.com

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.

• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• St Vincent Pediatric Subspecialties

  • Pediatrics Physician
  • Indianapolis, IN
  • NPI 1013967736

  Nurse Practitioner

  NPD (past)
• Witham Memorial Hospital

  • Family Medicine Physician
  • Lebanon, IN
  • NPI 1083750293
  NPD (past)
• Witham Memorial Hospital

  • Physical Therapist
  • Zionsville, IN
  • NPI 1952282204
  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1952470106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 N LEBANON ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460521476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 N LEBANON ST STE 415",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460528621",
            "telephone_number": "765-485-8900",
            "fax_number": "765-485-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANDROCK",
        "first_name": "KIMBERLY",
        "middle_name": "S",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28152774A",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "71001322A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300069096",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khandrock@withamdirect.org",
            "affiliation": "Y",
            "affiliationName": "Witham Memorial Hospital",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2705 N Lebanon St Ste 415",
            "city": "Lebanon",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460528621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "ROLLER",
            "middle_name": "S",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Donna F Hagen, FNP
• Tehniat Haider, MD
• Philip D Hallett, D.C.
• Lacey Hamilton, NP
• Luke Hammett
• Brandon Harris, PHARMD
• Paris Harris, RBT
• Alana C Hart, NP
• Phoebe Harvey, RBT
• Megan Haselrig, RBT

• Pediatric Nurse Practitioner in Lebanon, IN
• Providers in Lebanon, IN by specialty
• Pediatric Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.