Individual provider Active NPI

John M Kimple, M.D.

  • Family Medicine Physician
  • Redding, CA
National Provider Identifier
1013947605
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G29775 Issued in CA
Practice address
2510 Airpark Dr
Suite 201
Redding, CA 96001-2449
Phone
(530) 244-4034
Fax
(530) 244-1821
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G29775 CA Primary

Addresses

Primary practice location

2510 Airpark Dr
Suite 201
Redding, CA 96001-2449

Mailing address

2510 Airpark Dr
Suite 201
Redding, CA 96001-2449
Phone (530) 244-4034

Other identifiers 1

IdentifierTypeStateIssuer
00G297750MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G29775CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013947605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 AIRPARK DR",
            "address_2": "SUITE 201",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012449",
            "telephone_number": "530-244-4034",
            "fax_number": "530-244-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 AIRPARK DR",
            "address_2": "SUITE 201",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012449",
            "telephone_number": "530-244-4034",
            "fax_number": "530-244-1821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMPLE",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G29775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G297750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.