KIMBERLY S SQUIRES (NPI# 1871735068) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871735068 |
| Entity Type | Individual |
| Full Name | KIMBERLY S SQUIRES |
| Credential | FNP-C; PMHNP-BC |
| Practice Address |
10320 Mallard Creek Rd Ste 240 Charlotte NC 28262-9756 |
| Practice Telephone | 7048868703 |
| Mailing Telephone | 7048868703 |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2016-07-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 218478 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
2008001301 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
2014029878 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | ETN P97980 | 5004974 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467420620 | Kimberly H Squires | Nurse Practitioner | 600 Highland Ave, Madison, WI 53792 | 2006-03-14 |
| Street Address |
10320 MALLARD CREEK RD STE 240 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28262-9756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912987975 | William G. Katibah IIi | Family Medicine | 10320 Mallard Creek Rd, Suite 100, Charlotte, NC 28262-9756 | 2006-01-18 |
| 1780033233 | Integrated Behavioral Health Management | Clinic/Center | 10320 Mallard Creek Rd, Suite 240, Charlotte, NC 28262-5208 | 2016-06-06 |
| 1558775015 | Allison Petrilli Knox | Physician Assistant | 10320 Mallard Creek Rd, Suite 100, Charlotte, NC 28262-9756 | 2014-06-12 |
| 1881952117 | Carolinas Medical Center At Home, LLC | Durable Medical Equipment & Medical Supplies | 10320 Mallard Creek Rd, Suite 230, Charlotte, NC 28262-9756 | 2012-04-24 |
| 1982992376 | Rosemarie Gentle | Physical Therapist | 10320 Mallard Creek Rd, Suite 275, Charlotte, NC 28262-9756 | 2011-07-19 |
| 1578863007 | Stacy Marie Sannem | Physical Therapist | 10320 Mallard Creek Rd, Ste 275, Charlotte, NC 28262-9756 | 2010-11-01 |
| 1619208030 | S.j.burrow,iii.d.d.s.,m.s.,p.l.l.c. | Dentist | 10320 Mallard Creek Rd, Suite 150, Charlotte, NC 28262-9756 | 2010-01-25 |
| 1801067327 | David H. Moore Dds, Ms, Pa | Dentist | 10320 Mallard Creek Rd, Suite 150, Charlotte, NC 28262-9756 | 2008-03-13 |
| 1518174820 | William George Katibah IIi | Family Medicine | 10320 Mallard Creek Rd, Suite 100, Charlotte, NC 28262-9756 | 2007-05-17 |
| 1639386162 | R. Holt Foushee, Dds, Ms | Clinic/Center | 10320 Mallard Creek Rd, Suite 140, Charlotte, NC 28262-9756 | 2007-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366056913 | Aleta Michelle Johnson | Specialist | 9711 David Taylor Dr., Ste. 145, Charlotte, NC 28262 | 2020-09-01 |
| 1275161580 | Londyn Homecare Agency L.l.c | Home Health | 1914j.n. Place, Charlotte, NC 28262 | 2020-03-31 |
| 1154964914 | Abundant Love Home Care Service LLC | In Home Supportive Care | 1981 J.n. Pease Place, Ste 204, Charlotte, NC 28262 | 2019-10-24 |
| 1104399070 | Nattya S Pilgreen | Prosthetist | 410 E Mccullough Drive, Suite 103, Charlotte, NC 28262 | 2019-01-03 |
| 1114404506 | Laura Ida Anthony-getant | Social Worker | 10130 Mallard Creek Road, Ste 300 #333, Charlotte, NC 28262 | 2018-07-27 |
| 1720573587 | Carolinas Center for Ambulatory Dentistry LLC | Dentist | 8415 Medical Plaza Drice, Charlotte, NC 28262 | 2018-06-25 |
| 1598254799 | Cassandra Faye Harding | Nurse Practitioner | 1905 Jn Pease Place Suite 103, Charlotte, NC 28262 | 2018-05-03 |
| 1669960746 | Michael Riley | In Home Supportive Care | 8301 University Exec Park Dr Ste 120, Charlotte, NC 28262 | 2018-04-25 |
| 1568989804 | Bridget Coomber | Behavior Technician | 8420 University Executive Dr Ste 810, Charlotte, NC 28262 | 2017-08-28 |
| 1073037701 | Toshana Daley | Physical Therapist | 8801 Jm Keynes Blvd, Charlotte, NC 28262 | 2017-08-03 |
| Find all providers in zip 28262 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881292134 | Jurell Kirice Riley | Nurse Practitioner | 6301 Dumont Ln, Charlotte, NC 28269-6147 | 2020-10-09 |
| 1669090213 | Rashonda R. Wheeler | Nurse Practitioner | 8949 Cinnabay Dr, Charlotte, NC 28216-2189 | 2020-07-10 |
| 1053934356 | New Heights Behavioral Health, Pllc | Nurse Practitioner | 4929 Jean Grimes Dr., #304, Charlotte, NC 28269-3061 | 2020-05-20 |
| 1578184594 | Like-way Healthcare Service | Nurse Practitioner | 7919 Mossycup Dr, Charlotte, NC 28215-7159 | 2020-04-30 |
| 1891330346 | Erika Natira Holmes | Nurse Practitioner | 6918 Lenhart Dr, Charlotte, NC 28226-9505 | 2019-11-07 |
| 1215467493 | Unique Psychiatric Care Solutions Pllc | Nurse Practitioner | 301 Mccullough Dr Rm 435, Charlotte, NC 28262-3310 | 2017-06-19 |
| 1649629130 | Ayanna Williams | Nurse Practitioner | 1822 Butterfly Ln, Charlotte, NC 28269-4044 | 2016-06-06 |
| 1083043913 | Karen Treasure | Nurse Practitioner | 13524 Porter Creek Rd, Charlotte, NC 28262-1660 | 2013-11-01 |
| 1689920357 | Laura Harvey Nazzaro | Nurse Practitioner | 10420 Park Rd Ste 300, Charlotte, NC 28210-8502 | 2012-07-31 |
| 1033400478 | Fredom Now Medical, Pllc | Nurse Practitioner | 9635 Southern Pine Blvd # 129, Charlotte, NC 28273-5558 | 2011-04-19 |
| Find all providers in CHARLOTTE | ||||
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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.