Mrs Kimberly Randall Booker, CNM, WHNP-BC is a medicare enrolled "Advanced Practice Midwife" in Reidsville, North Carolina. She graduated from nursing school in 2013 and has 11 years of diverse experience with area of expertise as Certified Nurse Midwife (cnm). She is a member of the group practice The Moses H Cone Memorial Hospital Operating Corporation and her current practice location is
520 Maple Ave, Suite C, Reidsville, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(336) 342-6063.
Mrs Kimberly Randall Booker is licensed to practice in North Carolina (license number 522) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1013359934.
Provider's Profile
| Full Name | Mrs Kimberly Randall Booker |
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| Gender | Female |
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| Speciality | Certified Nurse Midwife (cnm) |
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| Experience | 11 Years |
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| Location | 520 Maple Ave, Reidsville, North Carolina |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mrs Kimberly Randall Booker graduated from nursing school in 2013
NPI Data:
- NPI Number: 1013359934
- Provider Enumeration Date: 07/19/2013
- Last Update Date: 08/11/2021
Medicare PECOS Information:
- PECOS PAC ID: 8426292707
- Enrollment ID: I20130926000792
Medical Identifiers
Medical identifiers for Mrs Kimberly Randall Booker such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1013359934 | NPI | - | NPPES |
| 1799G | Other | | BCBS |
| Q44206A | Other | | MEDICARE INDIVIDUAL PTAN LINKED TO FACULTY PRACTICE GROUP |
| 1013359934 | Medicaid | NC | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LW0102X | Nurse Practitioner - Women's Health | BOO104379455 (North Carolina) | Secondary |
| 367A00000X | Advanced Practice Midwife | 522 (North Carolina) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| The Moses H Cone Memorial Hospital Operating Corporation | 6204744600 | 490 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Kimberly Randall Booker allows following entities to bill medicare on her behalf.
| Entity Name | The Moses H Cone Memorial Hospital Operating Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1356372064
PECOS PAC ID: 6204744600
Enrollment ID: O20031124000541 |
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| Entity Name | Moses Cone Physician Services, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1093953127
PECOS PAC ID: 4284782210
Enrollment ID: O20090501000202 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Kimberly Randall Booker is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Mrs Kimberly Randall Booker, CNM, WHNP-BC
3871 Vance Street Ext,
Reidsville, NC 27320-8873
Ph: (336) 613-0904 | Mrs Kimberly Randall Booker, CNM, WHNP-BC
520 Maple Ave, Suite C,
Reidsville, NC 27320-4652
Ph: (336) 342-6063 |
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