KIMBERLY M HARRIS (NPI# 1306380555) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306380555 |
| Entity Type | Individual |
| Full Name | KIMBERLY M HARRIS |
| Credential | APN |
| Practice Address |
1340 Charles St Ste 300 Rockford IL 61104-2200 |
| Mailing Address |
Po Box 78866 Milwaukee WI 53278-8866 |
| Practice Telephone | 7796965888 |
| Practice Fax Number | 7796965898 |
| Mailing Telephone | 7796967150 |
| Mailing Fax Number | 7796967342 |
| Enumeration Date | 2016-12-07 |
| Last Update Date | 2019-06-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209.015193 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2550 Hauser Ross Drive, Suite 350, Sycamore, IL 601783180 | 8157587700 | 8157566103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669084828 | Kimberly O Harris | Behavioral Analyst | 225 E. Rincon St., Suite 219, Corona, CA 92879 | 2020-08-19 |
| 1144706557 | Kimberly Harris | Specialist/Technologist | 3221 Havenwood Ct, Palatine, IL 60067-9054 | 2018-07-18 |
| 1114437852 | Kimberly Zella Harris | Social Worker | 1841 Fairmount Ave, Cincinnati, OH 45214-1224 | 2017-10-09 |
| 1043751449 | Kimberly Harris | Nurse Practitioner | 4805 Purdue Dr, Boynton Beach, FL 33436-7721 | 2017-03-17 |
| 1669842878 | Kimberly Harris | Counselor | 7425 Los Guilicos Rd., Dept. H, Santa Rosa, CA 95409 | 2015-09-30 |
| 1609262351 | Kimberly Harris | Dietitian, Registered | 191 Brassie Ln, Summerfield, NC 27358-8612 | 2015-04-09 |
| 1952795940 | Kimberly Harris | Contractor | 23044 Crossley Ave, Hazel Park, MI 48030-1602 | 2015-03-27 |
| 1356731947 | Kimberly Malcomb Harris | Speech-Language Pathologist | 1056 S. Hwy 27, Suite 9, Somerset, KY 42501 | 2015-02-03 |
| 1124432729 | Kimberly Michele Harris | Licensed Practical Nurse | 1711 Newton Ave, Dayton, OH 45406-4044 | 2014-06-12 |
| 1033558861 | Kimberly A Harris | Nurse Practitioner | 1100 Northmeadow Parkway, Suite 108, Roswell, GA 30076-3871 | 2013-06-14 |
| Street Address |
1340 CHARLES ST STE 300 |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61104-2200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427052273 | Justin T Mao | Internal Medicine | 1340 Charles St Ste 300, Rockford, IL 61104-2200 | 2005-06-09 |
| 1215496914 | Elizabeth C Zook | Registered Nurse | 1340 Charles St Ste 300, Rockford, IL 61104-2200 | 2019-03-13 |
| 1639429855 | Danielle Jordal | Nurse Practitioner | 1340 Charles St Ste 300, Rockford, IL 61104-2200 | 2012-09-14 |
| 1801121405 | Christine L. Valentine | Nurse Practitioner | 1340 Charles St Ste 300, Rockford, IL 61104-2200 | 2009-10-15 |
| 1477704252 | Mazen Hadid | Internal Medicine | 1340 Charles St Ste 300, Rockford, IL 61104-2200 | 2008-10-09 |
| 1457516965 | Rehmat Ullah Sheikh | Internal Medicine | 1340 Charles St Ste 300, Rockford, IL 61104-2200 | 2008-07-23 |
| 1508060518 | Rebecca Jo Behling | Nurse Practitioner | 1340 Charles St Ste 300, Rockford, IL 61104 | 2007-06-13 |
| 1639260508 | Paul T Vaitkus | Internal Medicine | 1340 Charles St Ste 300, Rockford, IL 61104-2200 | 2006-09-27 |
| 1174553523 | John Carlton Myers | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1340 Charles St Ste 300, Rockford, IL 61104-2200 | 2006-07-03 |
| 1871574301 | Ian J Goldberg | Internal Medicine | 1340 Charles St Ste 300, Rockford, IL 61104-2200 | 2005-11-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699216564 | Swedishamerican Hospital | Nutritionist | 1415 E. State St., Lower Level A3, Rockford, IL 61104 | 2017-03-13 |
| 1376950485 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 200, Rockford, IL 61104 | 2014-07-21 |
| 1871907774 | Oday Alsarraf | Psychiatry & Neurology | 1401 E State Street, Center for Mental Health, Swedish American Hospital, Rockford, IL 61104 | 2014-06-18 |
| 1962652339 | Children's Home and Aid | Community/Behavioral Health | 424 7th St, Rockford, IL 61104 | 2008-09-23 |
| 1689729535 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 100, Rockford, IL 61104 | 2007-01-23 |
| 1790873016 | David J Schleicher | Obstetrics & Gynecology | 209 9th St Ste 200, Rockford, IL 61104 | 2006-10-11 |
| 1013026624 | Thomas Ryan Moss | Dentist | 1415 E State Street, Rockford, IL 61104 | 2006-08-29 |
| 1366452096 | Arturo Santiago Manas | Obstetrics & Gynecology | 1415 E State St Fl 8, Rockford, IL 61104 | 2006-08-08 |
| 1245263268 | William John Stout | Physician Assistant | 1401 E State Street, Rockford, IL 61104 | 2006-07-10 |
| 1689604969 | Prabha Chand Dosi | Pediatrics | 1401 E. State Street, Rockford, IL 61104 | 2006-07-03 |
| Find all providers in zip 61104 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174138481 | Kelly Ann Twigg | Nurse Practitioner | 5669 Shelley Rd, Rockford, OH 45882-9577 | 2020-09-14 |
| 1699389882 | Mary Ann Shaw | Nurse Practitioner | 207 W Main Ave, Rockford, IA 50468-1213 | 2020-09-04 |
| 1124632922 | Catherine Nwosu | Nurse Practitioner | 3455 Holiday Dr Apt 10, Rockford, IL 61109-2489 | 2020-08-31 |
| 1790314631 | Toni A Hughart | Nurse Practitioner | 6000 E State St, Rockford, IL 61108-2521 | 2020-04-03 |
| 1578199220 | Keli S Griseta | Nurse Practitioner | 3505 N Bell School Rd, Rockford, IL 61114-6624 | 2020-03-13 |
| 1457986069 | Nicole P Falatic | Nurse Practitioner | 153 Glen Eagle Dr Ne, Rockford, MI 49341-1183 | 2020-03-04 |
| 1194367912 | Matt J Kriebs | Nurse Practitioner | 1235 N Mulford Rd Suite 103, Rockford, IL 61107 | 2019-10-14 |
| 1952869943 | Angela Marie Hawkins | Nurse Practitioner | 8201 E. Riverside Blvd, Pediatric Neurology, Rockford, IL 61114 | 2019-03-08 |
| 1487110540 | Karrie Hagger | Nurse Practitioner | 7476 Countryshire Ln, Rockford, IL 61107-2774 | 2019-02-13 |
| 1336652700 | Stacey Jo Caler | Nurse Practitioner | 363 Financial Ct Unit 300, Rockford, IL 61107-6671 | 2017-11-08 |
| Find all providers in ROCKFORD | ||||
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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.