MS. KIMBERLY DIANE CANUPP AGACNP
NPI 1619552536
Nurse Practitioner - Acute Care in Gainesville, GA
About Ms. Kimberly Diane Canupp Agacnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. KIMBERLY DIANE CANUPP AGACNP (NPI 1619552536) is an individual acute care provider in Gainesville, Georgia, licensed in Georgia (APRN-RN268584) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS, is affiliated with Northeast Georgia Medical Center, Inc, and maintains a secondary practice location in Dahlonega.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Ms. Kimberly Diane Canupp Agacnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Kimberly Canupp reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Gainesville, GA 30501
- Reassigned Medicare billing, Georgia enrollment
- 1,172 clinicians in this Medicare group
Lawrenceville, GA 30046
- Reassigned Medicare billing, Georgia enrollment
- 275 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Northeast Georgia Medical Center, Inc
Acute Care Hospitals · Gainesville, GAUnion General Hospital
Acute Care Hospitals · Blairsville, GANorthside Hospital Gwinnett
Acute Care Hospitals · Lawrenceville, GAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 30501 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kimberly Canupp's NPI number?
The NPI number for Kimberly Canupp is 1619552536. It was assigned to this individual provider in the NPPES registry on March 11, 2021.
Where is Kimberly Canupp located?
Kimberly Canupp practices at 743 Spring St NE, Gainesville, GA 30501. The listed phone number is (770) 219-9000.
What is Kimberly Canupp's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.
Is Kimberly Canupp enrolled in Medicare?
Yes. Kimberly Canupp is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Kimberly Canupp's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Canupp reassigns Medicare benefits to 2 organizations: Northeast Georgia Physicians Group Inc (Gainesville, GA) and Gwinnett Physician Group, LLC (Lawrenceville, GA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kimberly Canupp's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Kimberly Canupp affiliated with any hospitals?
According to CMS data, Kimberly Canupp is affiliated with Northeast Georgia Medical Center, Inc, Union General Hospital and Northside Hospital Gwinnett.
When was this NPI record last updated?
The NPPES record for Kimberly Canupp was last updated on June 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Ms. Kimberly Diane Canupp, AGACNP · NPI 1619552536
Acute Care physician in Gainesville, Georgia. Individual provider, active in the CMS NPPES registry since March 11, 2021.
## Identity
- **NPI:** 1619552536 (Entity type: Individual)
- **Enumerated:** March 11, 2021
- **Primary specialty:** Nurse Practitioner - Acute Care · taxonomy 363LA2100X
- **State license:** APRN-RN268584 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 743 SPRING ST NE, Gainesville, GA 30501-3715
- **Phone:** (770) 219-9000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Northeast Georgia Physicians Group Inc (NPI 1891745212, Gainesville, GA); Gwinnett Physician Group, LLC (NPI 1578574661, Lawrenceville, GA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** June 25, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1619552536) · Data from the CMS NPPES public registry.