Kimberly Standefer, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN9449571 Issued in FL

Practice address

1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708

Phone

(850) 862-1111

NPI assigned

Feb 13, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, GA, FL3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DX Mso PLLCGroup PAC ID 7719131101, 88 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• DX Mso, PLLC

  • Urgent Care Clinic/Center
  • Chattanooga, TN
  • NPI 1225381148
  Medicare reassignment Care Compare group NPD
• Hospital Medicine Services of FL, LLC

  • Hospitalist Physician
  • Aventura, FL
  • NPI 1710684857
  Medicare reassignment NPD
• Hamilton Medical Center, Inc.

  • General Acute Care Hospital
  • Dalton, GA
  • NPI 1528056066
  Medicare reassignment NPD
• Hamilton Physician Group Inc

  • Cardiovascular Disease Physician
  • Dalton, GA
  • NPI 1235455569
  Medicare reassignment NPD
• Specialized Oxygen Services, LLC

  • Oxygen Equipment & Supplies (DME)
  • Cleveland, TN
  • NPI 1154509214
  NPD (past) Authorized official
• Specialized Oxygen Services, LLC

  • Oxygen Equipment & Supplies (DME)
  • Hixson, TN
  • NPI 1427003201
  NPD (past) Authorized official
• Specialty Oxygen Services, Inc.

  • Oxygen Equipment & Supplies (DME)
  • Knoxville, TN
  • NPI 1013957786
  NPD (past) Authorized official
• Afc Urgent Care and Family Care of WNC, PLLC

  • Urgent Care Clinic/Center
  • Charlotte, NC
  • NPI 1679066658
  NPD (past)
• Dalton Cardiology, P.C.

  • Cardiovascular Disease Physician
  • Dalton, GA
  • NPI 1669491619
  NPD (past)
• Uhs Ventures

  • Urgent Care Clinic/Center
  • Sevierville, TN
  • NPI 1235669680
  NPD (past)

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

{
    "created_epoch": "1360713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1992044762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 965",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373430965",
            "telephone_number": "423-802-5143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476708",
            "telephone_number": "850-862-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1008 Executive Dr",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Hixson",
            "state": "TN",
            "postal_code": "373433991",
            "country_code": "US",
            "telephone_number": "423-802-5143",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3957 Cleveland Hwy",
            "address_purpose": "LOCATION",
            "city": "Dalton",
            "state": "GA",
            "postal_code": "307212052",
            "country_code": "US",
            "telephone_number": "706-529-3245",
            "fax_number": "706-272-6077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANDEFER",
        "first_name": "KIMBERLY",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-13",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "17410",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN229640",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9449571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Stein Eye Care, Inc.

• Family Nurse Practitioner in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.