NPIMap

Individual provider Active NPI

Barry Paul Kimberley, MD

  • Otolaryngology Physician
  • Newton, KS
National Provider Identifier
1063417012
Registry record updated Sep 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
28948 Issued in MN
Practice address
800 Medical Center Dr
Suite 230
Newton, KS 67114-7808
Phone
(316) 283-2828
Fax
(316) 283-2830
NPI assigned
Jun 16, 2005
Last updated
Sep 25, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 28948 MN Primary
Sleep Medicine (Otolaryngology) Physician 207YS0012X 28948 MN

Addresses

Primary practice location

800 Medical Center Dr
Suite 230
Newton, KS 67114-7808

Mailing address

800 Medical Center Dr
Suite 230
Newton, KS 67114-7808
Phone (316) 283-2828

Other identifiers 2

IdentifierTypeStateIssuer
200577150AMedicaidKS
759469100MedicaidMN

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)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
28948MNMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
ENT & Sleep Clinics Minnesota LLC Sleep Medicine PastSince Oct 1, 2012 Accepting new patients
Neosom Clinics Dba ENT & Sleep Medicine Otolaryngology Past Accepting new patients
Paparella Ear Head & Neck Institute PA Otolaryngology PastSince Sep 1, 1995 Accepting new patients

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348531200000",
    "number": "1063417012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MEDICAL CENTER DR",
            "address_2": "SUITE 230",
            "city": "NEWTON",
            "state": "KS",
            "postal_code": "671147808",
            "telephone_number": "316-283-2828",
            "fax_number": "316-283-2830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MEDICAL CENTER DR",
            "address_2": "SUITE 230",
            "city": "NEWTON",
            "state": "KS",
            "postal_code": "671147808",
            "telephone_number": "316-283-2828",
            "fax_number": "316-283-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBERLEY",
        "first_name": "BARRY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2012-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MN",
            "license": "28948",
            "primary": true
        },
        {
            "code": "207YS0012X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "MN",
            "license": "28948",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200577150A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "759469100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, KS

Sources for this page

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