Active NPI
Miles Kimbrough
- Internal Medicine Physician
- Oklahoma City, OK
National Provider Identifier
1205511896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 0594R
- Practice address
- 1200 Childrens Ave
Oklahoma City, OK 73104-4637 - Phone
- (405) 271-4417
- NPI assigned
- Jun 20, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0594R | OK | Primary |
Addresses
Primary practice location
1200 Childrens Ave
Oklahoma City, OK 73104-4637
Mailing address
2325 Good Wood Cir
Cary, NC 27513-2037
Phone (417) 576-0571
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0594R | OK | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687219200000",
"number": "1205511896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2325 GOOD WOOD CIR",
"city": "CARY",
"state": "NC",
"postal_code": "275132037",
"telephone_number": "417-576-0571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 CHILDRENS AVE",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731044637",
"telephone_number": "405-271-4417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMBROUGH",
"first_name": "MILES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-20",
"last_updated": "2023-06-20",
"certification_date": "2023-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OK",
"license": "0594R",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.