Individual provider Active NPI

Kimberly L Mabry-Paroline, APRN, NP-C,PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Longview, TX
National Provider Identifier
1104460328
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP143726 Issued in TX
Practice address
107 Woodbine PL
Longview, TX 75601-2912
Phone
(903) 758-2471
NPI assigned
Oct 30, 2019
Last updated
Nov 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP143726 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP143726 TX Primary

Addresses

Primary practice location

107 Woodbine PL
Longview, TX 75601-2912

Mailing address

523 S Fannin Ave
Tyler, TX 75702-8204
Phone (903) 535-9041

Other names 1

  • Kimberly L Mabry Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20200127002031 TX Practitioner - Nurse Practitioner 4880029537 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1300 N 6TH St
Community Healthcore Longview
Longview, TX 75601-5567
Phone (903) 297-1852

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP143726TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa of Texas PLLC CurrentSince Jan 15, 2021 Accepting new patients
Vpa of Texas PLLC Current Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Jan 15, 2021 Accepting new patients
Advanced Health Center PLLC CurrentSince Apr 7, 2022 Accepting new patients
Tyler Family Circle of Care CurrentSince Jan 19, 2025 Accepting new patients
Vpa of Texas PLLC CurrentSince Jan 15, 2021 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511

1400 W Southwest Loop 323
Ste 60
Tyler, TX 75701
Phone (903) 526-4875

523 S Fannin Ave
Tyler, TX 75702

928 N Glenwood Blvd
Tyler, TX 75702
Phone (903) 533-7400

Organizations & group practices 8

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": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1104460328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 S FANNIN AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028204",
            "telephone_number": "903-535-9041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 WOODBINE PL",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756012912",
            "telephone_number": "903-758-2471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABRY-PAROLINE",
        "first_name": "KIMBERLY",
        "middle_name": "L",
        "credential": "APRN, NP-C,PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP143726",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP143726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "MABRY",
            "middle_name": "L",
            "credential": "APRN, FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.