Leslie Anne Kimbrell, MSPT

Primary specialty

SpecialistTaxonomy code 174400000X

License

PT006329 Issued in GA

Practice address

4852 Old Alma Rd
Blackshear, GA 31516-4521

Phone

(912) 337-5588

NPI assigned

Jul 25, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343174400000",
    "number": "1013263235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4852 OLD ALMA RD",
            "city": "BLACKSHEAR",
            "state": "GA",
            "postal_code": "315164521",
            "telephone_number": "912-337-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4852 OLD ALMA RD",
            "city": "BLACKSHEAR",
            "state": "GA",
            "postal_code": "315164521",
            "telephone_number": "912-337-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBRELL",
        "first_name": "LESLIE",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-25",
        "last_updated": "2012-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NH",
            "license": "3555",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "PT006329",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MA",
            "license": "19645",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "1212716",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney L Hayes, FNP
• Erin Hodges, NP
• Kim Bradley Hood, DMD PC
• Yoo Bin Jin
• Mary Johnson, PHARMD
• Carli Knowlton, NP
• Kristy Michelle Knowlton, RBT
• Laboratory Corporation of America Holdings
• Robert S Littell, DC
• David Lawrence Madray IV, PHARM.D.

• Specialist in Blackshear, GA
• Providers in Blackshear, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.