NPIMap

Individual provider Active NPI

Kimberly Allison Glidewell, M.S., PA-C

  • Physician Assistant
  • Caldwell, TX
National Provider Identifier
1124056189
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA04405 Issued in TX
Practice address
1103 Woodson Dr
Caldwell, TX 77836-1052
Phone
(979) 567-7080
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA04405 TX Primary

Addresses

Primary practice location

1103 Woodson Dr
Caldwell, TX 77836-1052

Mailing address

912 Lorey LN
Caldwell, TX 77836-1359
Phone (979) 224-3866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091027000195 TX Practitioner - Physician Assistant 3173660099 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brazos Valley Community Action Agency Inc 41 clinicians

Practice addresses (Care Compare)

1103 Woodson Dr
Caldwell, TX 77836-1052
Phone (979) 567-7080

3370 S Texas Ave
Bryan, TX 77802-3127
Phone (979) 595-1700

8310 Hwy 6 Loop
Navasota, TX 77868-3248
Phone (936) 825-0000

Hospital & facility affiliations

  • CHI St Joseph Health Regional Hospital Hospital, Bryan, TX, CCN 450011
  • Burleson St Joseph Health Center Hospital, Caldwell, TX, CCN 451305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA04405TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brazos Valley Community Action Agency, Inc. Current Accepting new patients
DCS Medical PA CurrentSince Oct 21, 2025 Accepting new patients
Brazos Valley Community Action Agency, Inc CurrentSince Jun 3, 2024 Accepting new patients
DCS Medical PA CurrentSince Oct 21, 2025 Accepting new patients
Brazos Valley Community Action Agency, Inc. CurrentSince Jun 3, 2024 Accepting new patients
Partners in Chronic Disease Management Inc PastSince Mar 1, 2013 Accepting new patients
Rapidcare Clinic PA Past Accepting new patients
Jojoha, LLC Past Accepting new patients

Locations

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

3201 University Dr E
Ste 135
Bryan, TX 77802
Phone (979) 703-1832

1103 Woodson Dr
Caldwell, TX 77836
Phone (979) 567-7080

1500 University Dr E
College Station, TX 77840
Phone (979) 693-7400

1500 University Dr E
Ste 100
College Station, TX 77840
Phone (979) 383-2340

2901 W 7th Ave
Corsicana, TX 75110
Phone (903) 616-0111

8310 Highway 6 Loop
Navasota, TX 77868
Phone (936) 825-0000

Interoperability endpoints

  • Direct secure messaging: kimberly.glidewell@hptx.eclinicaldirectplus.com
  • Direct secure messaging: kglidewell@caldwellhltpt.direct.st-joseph.md

Organizations & group practices 20

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.

View all 20

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1124056189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 LOREY LN",
            "city": "CALDWELL",
            "state": "TX",
            "postal_code": "778361359",
            "telephone_number": "979-224-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 WOODSON DR",
            "city": "CALDWELL",
            "state": "TX",
            "postal_code": "778361052",
            "telephone_number": "979-567-7080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLIDEWELL",
        "first_name": "KIMBERLY",
        "middle_name": "ALLISON",
        "name_prefix": "Mrs.",
        "credential": "M.S., PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, TX

Sources for this page

Verify at the official NPI Registry.