Lisa Nicole Kimble

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

110 W Maple St
Stilwell, OK 74960-3100

Phone

(918) 797-7786

NPI assigned

Jun 5, 2017

Last updated

Jun 6, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Tenkiller Behavioral Services, Inc.

  • Community/Behavioral Health Agency
  • Stilwell, OK
  • NPI 1376967216
  NPD (past)

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496707200000",
    "number": "1083143036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27273 HIGHWAY 100",
            "city": "BUNCH",
            "state": "OK",
            "postal_code": "749312094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W MAPLE ST",
            "city": "STILWELL",
            "state": "OK",
            "postal_code": "749603100",
            "telephone_number": "918-797-7786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBLE",
        "first_name": "LISA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-05",
        "last_updated": "2017-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janel Johnson, D.O.
• Jared Jones
• Eleacia Lerayne Jordan
• Angela S Kester
• Stephanie L Killough
• Brenda Kincaid
• Megan Nicole Kirk, M.S., CCC-SLP
• Madison Kitchens, PA
• Jennifer Kliest, RDH
• Vikrant Laxman Landge, MD

• Case Manager/Care Coordinator in Stilwell, OK
• Providers in Stilwell, OK by specialty
• Case Manager/Care Coordinator in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2017; 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.