Individual provider Active NPI

Agyingi Kimbong, MD

  • Internal Medicine Physician
  • Lafayette, LA
National Provider Identifier
1104312776
Registry record updated Oct 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
54556 Issued in KY
Practice address
1214 Coolidge Blvd
Lafayette, LA 70503-2621
Phone
(337) 289-7991
NPI assigned
Jul 7, 2018
Last updated
Oct 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 54556 KY Primary
Internal Medicine Physician 207R00000X DR.0076845 CO
Hospitalist Physician 208M00000X 346344 LA
Hospitalist Physician 208M00000X DR.0076845 CO

Addresses

Primary practice location

1214 Coolidge Blvd
Lafayette, LA 70503-2621

Mailing address

3601 4TH St # Ms 6211
Lubbock, TX 79430-0002

Other practice location 1

3601 4th St # MS 6211
Lubbock, TX 79430-0002
Phone (806) 743-6840

Other practice location 2

2222 N Nevada Ave
Colorado Springs, CO 80907-6819
Phone (719) 776-8040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, OK, LA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210804004150 KY Practitioner - Internal Medicine 9032460944 Reassigns benefits to 1 organization
I20250609000554 OK Practitioner - Hospitalist 9032460944 Reassigns benefits to 1 organization
I20251117003818 LA Practitioner - Internal Medicine 9032460944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coolidge Physician Services LLCGroup PAC ID 7113156035, 52 clinicians
Warren Clinic IncGroup PAC ID 8820900293, 787 clinicians

Practice addresses (Care Compare)

1214 Coolidge Blvd
Lafayette, LA 70503-2621
Phone (337) 289-7991

6161 S Yale Ave
Tulsa, OK 74136-1902
Phone (918) 502-4720

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0076845COMDInternal Medicine Physician
346344LAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Kentucky, PSC Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients
Warren Clinic Inc CurrentSince Jul 7, 2025 Accepting new patients
Coolidge Physician Services LLC Hospitalist CurrentSince Oct 5, 2025 Accepting new patients
Hospitalist Medicine Physicians of Indiana, LLC Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients
Lafayette General Medical Center Inc Past Accepting new patients
Saint Joseph Health System, Inc Past Accepting new patients

Locations

150 N Eagle Creek Dr
Lexington, KY 40509
Phone (859) 267-9773

1001 Saint Joseph Ln
London, KY 40741
Phone (606) 330-6000

1214 Coolidge Blvd
Lafayette, LA 70503
Phone (337) 234-9191

300 Rockefeller Dr
Muskogee, OK 74401
Phone (918) 682-5501

6161 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-2200

6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-5600

Organizations & group practices 6

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1530921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791417600000",
    "number": "1104312776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 4TH ST # MS 6211",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794300002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 COOLIDGE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032621",
            "telephone_number": "337-289-7991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 4th St # MS 6211",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794300002",
            "country_code": "US",
            "telephone_number": "806-743-6840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2222 N Nevada Ave",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809076819",
            "country_code": "US",
            "telephone_number": "719-776-8040",
            "fax_number": "719-776-8050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMBONG",
        "first_name": "AGYINGI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-07",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "54556",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0076845",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "LA",
            "license": "346344",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CO",
            "license": "DR.0076845",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.