Individual provider Active NPI

Kimberly Hinman, PHD

  • Psychologist
  • Kansas City, MO
National Provider Identifier
1154941359
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2021002658 Issued in MO
Practice address
17 W 66TH St
Kansas City, MO 64113-1825
Phone
(518) 209-8508
NPI assigned
Apr 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X NY
Psychologist 103T00000X 2021002658 MO Primary

Addresses

Primary practice location

17 W 66TH St
Kansas City, MO 64113-1825

Mailing address

17 W 66TH St
Kansas City, MO 64113-1825
Phone (518) 209-8508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210219000185 MO Practitioner - Clinical Psychologist 6901211218 Practice locations: Kansas City, MO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6315 Walnut St
Kansas City, MO 64113-2313

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021002658MOMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas City Testing and Assessment Current Accepting new patients
Holistic Care Counseling LLC Psychologist Current Accepting new patients
Attention Disorders Clinic of Kansas City Current Accepting new patients

Locations

6315 Walnut St
Kansas City, MO 64113
Phone (518) 209-8508

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1587081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1154941359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 W 66TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641131825",
            "telephone_number": "518-209-8508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 W 66TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641131825",
            "telephone_number": "518-209-8508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINMAN",
        "first_name": "KIMBERLY",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-17",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "2021002658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.