Individual provider Active NPI

Kimberly Jean Kinney, RN, NP

  • Women's Health Nurse Practitioner
  • Savannah, GA
National Provider Identifier
1982679189
Registry record updated Aug 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
RN226089 Issued in GA
Practice address
5354 Reynolds St Ste 422
Savannah, GA 31405-6011
Phone
(912) 721-9499
Fax
(912) 721-9518
NPI assigned
Feb 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 0024164385 VA
Registered Nurse 163W00000X 0001151070 VA
Women's Health Nurse Practitioner 363LW0102X RN226089 GA Primary

Addresses

Primary practice location

5354 Reynolds St Ste 422
Savannah, GA 31405-6011

Mailing address

5354 Reynolds St Ste 422
Savannah, GA 31405-6011
Phone (912) 721-9499

Other identifiers 4

IdentifierTypeStateIssuer
04093OtherNCNC BC/BS
10029400NOtherVASENTARA/OPTIMA
7004093MedicaidNC
1982679189MedicaidVA

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
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001151070VAMDRegistered Nurse
RN226089GAMDWomen's Health Nurse Practitioner
0024164385VAMDWomen's Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376870400000",
    "number": "1982679189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5354 REYNOLDS ST STE 422",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056011",
            "telephone_number": "912-721-9499",
            "fax_number": "912-721-9518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5354 REYNOLDS ST STE 422",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056011",
            "telephone_number": "912-721-9499",
            "fax_number": "912-721-9518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNEY",
        "first_name": "KIMBERLY",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "RN, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2013-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "VA",
            "license": "0024164385",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001151070",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "RN226089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BC/BS",
            "identifier": "04093",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA/OPTIMA",
            "identifier": "10029400N",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7004093",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982679189",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; 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.