MRS. KIMBERLY LYNN KING (NPI# 1447361175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447361175 |
| Entity Type | Individual |
| Full Name | MRS. KIMBERLY LYNN KING |
| Other Name | MRS. KIMBERLY LYNN PONDER |
| Credential | FNP |
| Practice Address |
4450 Highland Ave Beaumont TX 77705 |
| Mailing Address |
Po Box 66308 Houston TX 77266-6308 |
| Practice Telephone | 8325485000 |
| Practice Fax Number | 4092422526 |
| Mailing Telephone | 8325485000 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-04-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | AP114235 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP114235 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LEGACY COMMUNITY HEALTH SERVICES INC SITE SPECIFIC MEDICARE | 741809 | 01 | |
| TX | LEGACY COMMUNITY HEALTH SERVICES, INC. MEDICAID NUMBER | 080462703 | 01 |
| TX | TEXAS NURSING LICENSE | AP114235 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447604434 | Kimberly King | Health Maintenance Organization | 5848 Bellingrath Way, Lithonia, GA 30058-3212 | 2016-04-16 |
| 1386025807 | Kimberly King | Counselor | 3620 Stutz Dr, Canfield, OH 44406-9176 | 2015-06-10 |
| 1285932632 | Kimberly Anne King | Physical Therapist | 1213 Osbourne Ave, Abington, PA 19001-2901 | 2011-03-09 |
| 1487958336 | Kimberly Denise King | Counselor | 16108 E 2nd St, Tulsa, OK 74108-1729 | 2011-01-07 |
| 1992840607 | Kimberly A King | Dentist | 1220 N Velasco St, Angleton, TX 77515-3010 | 2007-02-20 |
| 1457426397 | Kimberly King | Dentist | 53 Wright Brothers Ave Ste C, Livermore, CA 94551-9465 | 2006-11-22 |
| 1720057011 | Kimberly Rae King | Audiologist | 640 6th Ave S, North Myrtle Beach, SC 29582-3310 | 2006-03-17 |
| 1437120326 | Kimberly B. King | Physical Therapy Assistant | 1000 Western Blvd, Tarboro, NC 27886-4017 | 2006-01-30 |
| 1033189824 | Kimberly Suzanne King | Nurse Practitioner | 350 Langdon St, Somerset, KY 42503-2786 | 2006-01-24 |
| 1033730486 | Kimberly King | Licensed Vocational Nurse | 9846 Hwy 31 E, Tyler, TX 75705-2329 | 2020-04-27 |
| Street Address |
4450 HIGHLAND AVE |
| City | BEAUMONT |
| State | TX |
| Zip Code | 77705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275536740 | Kimberlie J Gonzalez | Family Medicine | 4450 Highland Ave, Beaumont, TX 77705-5205 | 2005-05-27 |
| 1366812000 | Rachel Adams | Nurse Practitioner | 4450 Highland Ave, Beaumont, TX 77705-5205 | 2015-10-06 |
| 1447671987 | Rose Brooks Lorenzen | Counselor | 4450 Highland Ave, Beaumont, TX 77705-5205 | 2013-12-31 |
| 1235482878 | Legacy Community Health Services, Inc | Clinic/Center | 4450 Highland Ave, Beaumont, TX 77705-5205 | 2012-10-19 |
| 1598037608 | Cynthia Renee Roland | Obstetrics & Gynecology | 4450 Highland Ave, Beaumont, TX 77705 | 2012-02-04 |
| 1932483526 | Gaurav Puri Pa | Dentist | 4450 Highland Ave, Beaumont, TX 77705-5205 | 2011-10-01 |
| 1508173170 | Charukesi Chandrasekaran | Psychiatry & Neurology | 4450 Highland Ave, Beaumont, TX 77705-5205 | 2010-09-02 |
| 1689801730 | Harry Jae Doyle | Nurse Practitioner | 4450 Highland Ave, Beaumont, TX 77705-5205 | 2009-06-16 |
| 1093957417 | Rhonda S Dixon | Registered Nurse | 4450 Highland Ave, Beaumont, TX 77705-5205 | 2009-03-31 |
| 1225190416 | Lois E Muhammad | Family Medicine | 4450 Highland Ave, Beaumont, TX 77705 | 2006-12-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801431390 | Iris Fiaui | Specialist/Technologist | 4400 Mlk Jr Pkwy, Beaumont, TX 77705 | 2019-11-08 |
| 1437644937 | Kolten Elizabeth Adams | Specialist/Technologist | 4400 S Mlk Jr Parkway, Beaumont, TX 77705 | 2018-06-27 |
| 1326443391 | Scott Forbes | Psychologist | 6200 Knauth Rd, Beaumont, TX 77705 | 2014-11-03 |
| 1518367622 | Dennis Agricola | Nurse Practitioner | 6200 Knauth Road, Beaumont, TX 77705 | 2014-08-26 |
| 1639591480 | Chs Texas Medical, P.a. | General Practice | 11357 Highway 10 Sw, Smith Rd, Beaumont, TX 77705 | 2014-01-14 |
| 1649523309 | Tri-medical Emergency Medical Services Lp | Ambulance | 4610 St. Louis St, Beaumont, TX 77705 | 2012-10-18 |
| 1437462785 | Cynthia Ksiazek | Social Worker | 857 E Virginia, Beaumont, TX 77705 | 2010-07-15 |
| 1457509424 | Gaurav Puri | Dentist | 4400 Highland Ave, Beaumont, TX 77705 | 2008-09-03 |
| 1588811731 | Prasad L Surapaneni | Family Medicine | 5430 Knauth Rd, Beaumont, TX 77705 | 2008-08-19 |
| 1891994612 | Jennifer Lien Truong | Occupational Therapist | 4205 Grandberry, Beaumont, TX 77705 | 2007-07-12 |
| Find all providers in zip 77705 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437614641 | Matthew Carter | Nurse Practitioner | 3030 North St Ste 460, Beaumont, TX 77702-1499 | 2019-02-01 |
| 1598272338 | Kare Infusion Center LLC | Nurse Practitioner | 6755 Phelan Blvd Ste 46, Beaumont, TX 77706-6077 | 2018-01-02 |
| 1407108715 | Garrett Benjamin Roy | Nurse Practitioner | 4347 Phelan Blvd Ste 101, Beaumont, TX 77707-2159 | 2012-10-10 |
| 1629328919 | Leslie F Anslem | Nurse Practitioner | 3080 College St., Beaumont, TX 77701-4606 | 2012-09-13 |
| 1003976531 | Lynda Marie Few | Nurse Practitioner | 3560 Delaware St # 601, Beaumont, TX 77706-3067 | 2006-12-12 |
| 1073525697 | Connie L Brown | Nurse Practitioner | 155 Ih-10 North, Ste: 1, Beaumont, TX 77707 | 2006-08-12 |
| 1508894528 | Tammy L Stout | Nurse Practitioner | 3406 College St # 100, Beaumont, TX 77701-4612 | 2006-06-29 |
| 1407884844 | Susan J Lundy | Nurse Practitioner | 3430 Fannin St, Beaumont, TX 77701-3803 | 2006-06-28 |
| 1932143351 | Emma Rachele Davis | Nurse Practitioner | 3060 Fm 3514, Beaumont, TX 77705 | 2006-06-15 |
| 1578513040 | Shawn Rooney Gray | Nurse Practitioner | 857 E. Virginia, Beaumont, TX 77705 | 2006-05-12 |
| Find all providers in BEAUMONT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.