Kenny Ray Kimball II, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

006743 Issued in KY

Practice address

1410 N Race St
Glasgow, KY 42141-3473

Phone

(270) 651-7882

NPI assigned

Dec 2, 2015

Sex

Male

Sole proprietor

Yes

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 KY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Graves Gilbert Clinic PLLCGroup PAC ID 4082511167, 207 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Graves Gilbert Clinic PLLC

  • Specialist
  • Bowling Green, KY
  • NPI 1114948288

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Graves Gilbert Clinic PLLC

  • Rural Health Clinic/Center
  • Cave City, KY
  • NPI 1104635663
  NPD
• H2 Rehabilitation Services of Kentucky, LLC

  • Rehabilitation Clinic/Center
  • Glasgow, KY
  • NPI 1740232404
  NPD (past)

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

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449014400000",
    "number": "1184099103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 LOVERS LN",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421411000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 N RACE ST",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421413473",
            "telephone_number": "270-651-7882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "KENNY",
        "middle_name": "RAY",
        "name_suffix": "II",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-02",
        "last_updated": "2015-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "006743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kentucky Center for the Prevention of Heart Attack Stoke and Diabetes
• Kentucky Dermatology Clinic, PLLC
• Kentucky Em-I Medical Services PSC
• Brenda Keown, LPCC
• Ryan B Kerrins, DNP, FNP-BC, CCRN
• Destiny A King, BCBA, LBA
• Myles King, RN
• Wendi Lee King, MD
• Erin R Kingrey, PHARM D
• Tyler Kirby

• Physical Therapist in Glasgow, KY
• Providers in Glasgow, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.