Kyle Kimbrough, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1568 Hwy 178 E
New Albany, MS 38652

Phone

(662) 316-5409

NPI assigned

Jun 24, 2014

Sex

Male

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

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Hattiesburg Clinic PA

  • Multi-Specialty Clinic/Center
  • Hattiesburg, MS
  • NPI 1740213446
  Medicare reassignment NPD
• First Intermed Corporation

  • Family Medicine Physician
  • Ridgeland, MS
  • NPI 1346275310
  NPD
• Hattiesburg Clinic, PA

  • Primary Care Clinic/Center
  • Flowood, MS
  • NPI 1912600354
  NPD

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403568000000",
    "number": "1104231695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 364",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "38652",
            "telephone_number": "662-316-5409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1568 HWY 178 E",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "38652",
            "telephone_number": "662-316-5409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBROUGH",
        "first_name": "KYLE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-24",
        "last_updated": "2014-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Jones, FNP
• Terry Michael Joslin, O.D.
• Sheldon Reid Kelly
• Jason W Kidd, ARPN
• Sado S Kim
• King Therapies
• Bailey C King, BCBA, LBA
• Knighton Chiropractic and Wellness Inc
• Brittney C Knighton, D.C.
• Sherry Lauronda Knox, LPC/MHSP

• Physician Assistant in New Albany, MS
• Providers in New Albany, MS by specialty
• Physician Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.