MS. KIMBERLY NICOLE THARP (AGACNP) – Acute Care Nurse Practitioner, NPI 1255858833

MS. KIMBERLY NICOLE THARP (AGACNP) is a healthcare provider. based in Dearborn heights, Michigan. specializing in Acute Care Nurse Practitioner. They hold the professional credentials AGACNP. They hold a License No. 4704253537 (MI). The NPI Number for MS. KIMBERLY NICOLE THARP (AGACNP) is 1255858833

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
MS. KIMBERLY NICOLE THARP (AGACNP)
NPI
1255858833
Phone
(248) 910-1694
Address
5690 LINCOLN BLVD
Enumeration Date
24 August 2017
Last Update Date
4 January 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2488257373
Graduation Year
2017 (9 years ago)
PAC ID
8921366469
Group Practice PAC ID
2961634795
Professional Enrollment ID
I20171211001730
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:8State licenses:1Digital endpointsOther names

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Provider Addresses for MS. KIMBERLY NICOLE THARP (AGACNP)

  • 5690, Lincoln Boulevard, Dearborn Heights, Wayne County, Michigan, 48125, United States

    DEARBORN HEIGHTS, MI 481252402

    Phone: (248) 910-1694

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $123.

Total Amount is formed as General ($123) + Research ($0) + Ownership ($0) = $123.

Last reported payment date: 2024-02-28 • Largest payer in this snapshot: PFIZER INC. ($123).

Total Amount

$123

General + Research + Ownership

Payments

1

Total payment records

General Amount

$123

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-02-28

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
PFIZER INC.$123
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.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-12-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20171211001730INurse PractitionerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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 48125)

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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: 2961634795View full group profile
NameSpecialtyState
Nurse PractitionerMI
-MI
-MI

Reviews

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Frequently asked questions

Where can patients find MS. KIMBERLY NICOLE THARP (AGACNP)'s NPI?
You can confirm MS. KIMBERLY NICOLE THARP (AGACNP) with NPI 1255858833; it appears in the national provider directory.
Is MS. KIMBERLY NICOLE THARP (AGACNP)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is MS. KIMBERLY NICOLE THARP (AGACNP)?
The page reflects Acute Care Nurse Practitioner for MS. KIMBERLY NICOLE THARP (AGACNP). Clinical services aligned with this taxonomy classification.
Where is MS. KIMBERLY NICOLE THARP (AGACNP)'s primary listing?
We display Dearborn Heights, Michigan because that is what the record indicates for MS. KIMBERLY NICOLE THARP (AGACNP).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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