Kimberly Boothby-Downing, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R024613 Issued in ME

Practice address

716 Stevens Ave
Portland, ME 04103-2656

Phone

(207) 221-4242

Fax

(207) 523-1913

NPI assigned

Dec 19, 2005

Sex

Female

Sole proprietor

No

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.

• University of New England

  • Family Medicine Physician
  • Biddeford, ME
  • NPI 1699752055

  Adult Health

  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 17, 2022.

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1972589331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 284",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053020284",
            "telephone_number": "207-221-4242",
            "fax_number": "207-523-1913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 STEVENS AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032656",
            "telephone_number": "207-221-4242",
            "fax_number": "207-523-1913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTHBY-DOWNING",
        "first_name": "KIMBERLY",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-19",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "ME",
            "license": "R024613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251010099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin Pryor Bonner, MD
• Daniel M Bonner, LMSW-CC
• Stevie Bonnevie, LADC
• Cameron R Bonney, MD
• Cora Boone, LCSW
• John A Boothby, M.D.
• Megan C. Boothby, LCSW
• Derina Boothroyd, AUD
• Jenifer Bordelon, LCSW, LADC, PMH-C
• Kyle Nelson Borges

• All providers in Portland, ME
• Adult Health Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; 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.