KIMBERLY BRIDZEKE STATON (APRN) – Psychiatric/Mental Health Nurse Practitioner, NPI 1003396391

KIMBERLY BRIDZEKE STATON (APRN) is a healthcare provider. based in Old lyme, Connecticut. specializing in Psychiatric/Mental Health Nurse Practitioner. They hold the professional credentials APRN. They hold a License No. AP138337 (TX). The NPI Number for KIMBERLY BRIDZEKE STATON (APRN) is 1003396391

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
KIMBERLY BRIDZEKE STATON (APRN)
NPI
1003396391
Phone
(800) 370-3651
Address
55 HATCHETTS HILL RD
Enumeration Date
16 August 2018
Last Update Date
16 August 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8003703651
Graduation Year
2018 (8 years ago)
PAC ID
5799035697
Group Practice PAC ID
4082512546
Professional Enrollment ID
I20180913000686
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

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Provider Addresses for KIMBERLY BRIDZEKE STATON (APRN)

  • 55, Hatchetts Hill Road, Old Lyme, New London County, Connecticut, 06371, United States

    OLD LYME, CT 063711534

    Phone: (800) 370-3651

    Fax: (877) 515-7147

    Type: Mailing

  • 620, East 7th Street, Dirty Sixth, Austin, Travis County, Texas, 78701, United States

    AUSTIN, TX 787023222

    Phone: (800) 370-3651

    Fax: (877) 515-7147

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 7 Open Payments records for all available years, with a total value of $631.

Total Amount is formed as General ($631) + Research ($0) + Ownership ($0) = $631.

Last reported payment date: 2024-08-15 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($310).

Total Amount

$631

General + Research + Ownership

Payments

7

Total payment records

General Amount

$631

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-15

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06371)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4082512546View full group profile

Reviews

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Frequently asked questions

What number should I use to identify KIMBERLY BRIDZEKE STATON (APRN) for billing?
Administrative and clinical systems typically use NPI 1003396391 for KIMBERLY BRIDZEKE STATON (APRN).
Should I treat KIMBERLY BRIDZEKE STATON (APRN) as an active provider?
Patients and plans typically see KIMBERLY BRIDZEKE STATON (APRN) as active in the national extract.
What does the directory say KIMBERLY BRIDZEKE STATON (APRN) does?
Insurance directories may phrase it differently, but here KIMBERLY BRIDZEKE STATON (APRN) maps to Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What city is tied to KIMBERLY BRIDZEKE STATON (APRN)?
The directory associates KIMBERLY BRIDZEKE STATON (APRN) with Old Lyme, Connecticut. Check all listed addresses for suites or satellite offices.
Who maintains KIMBERLY BRIDZEKE STATON (APRN)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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