Individual provider Active NPI

Kimberly Bell-Buckingham, RN

  • Registered Nurse
  • Kennesaw, GA
National Provider Identifier
1962068874
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN174106 Issued in GA
Practice address
3901 Brentmoor CT NW
Kennesaw, GA 30144-7120
Phone
(678) 779-0487
NPI assigned
May 15, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN174106 GA Primary

Addresses

Primary practice location

3901 Brentmoor CT NW
Kennesaw, GA 30144-7120

Mailing address

PO Box 1833
Kennesaw, GA 30156-8833
Phone (678) 779-0487

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
RN174106GAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1962068874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1833",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301568833",
            "telephone_number": "678-779-0487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 BRENTMOOR CT NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301447120",
            "telephone_number": "678-779-0487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELL-BUCKINGHAM",
        "first_name": "KIMBERLY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-15",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN174106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2019; 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.