Individual provider Active NPI

Heather Anne Kimble

  • In Home Supportive Care Agency
  • Three Rivers, MI
National Provider Identifier
1194585117
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Practice address
628 S Lincoln Ave
Three Rivers, MI 49093-2026
Phone
(269) 625-1911
NPI assigned
Mar 19, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

628 S Lincoln Ave
Three Rivers, MI 49093-2026

Mailing address

628 S Lincoln Ave
Three Rivers, MI 49093-2026
Phone (269) 625-1911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1194585117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 S LINCOLN AVE",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490932026",
            "telephone_number": "269-625-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 S LINCOLN AVE",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490932026",
            "telephone_number": "269-625-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBLE",
        "first_name": "HEATHER",
        "middle_name": "ANNE",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Three Rivers, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.