Caroline Lee Kimbrough, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12711 Issued in MN

Practice address

200 1St St SW
Rochester, MN 55905

Phone

(507) 284-2511

NPI assigned

Mar 12, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Caroline Lee Olson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Coastal Health & Wellness

  • Federally Qualified Health Center (FQHC)
  • Texas City, TX
  • NPI 1578588406
  NPD (past)

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

{
    "created_epoch": "1489276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1255872115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "55905",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9850 Emmett F Lowry Expy Ste C",
            "address_purpose": "LOCATION",
            "city": "Texas City",
            "state": "TX",
            "postal_code": "775912001",
            "country_code": "US",
            "telephone_number": "409-938-2234",
            "fax_number": "409-949-3492",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9850 Emmett F Lowry Expy Ste C",
            "address_purpose": "LOCATION",
            "city": "Texas City",
            "state": "TX",
            "postal_code": "775912001",
            "country_code": "US",
            "telephone_number": "409-938-2234",
            "fax_number": "409-949-3492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMBROUGH",
        "first_name": "CAROLINE",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-12",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLINE",
            "last_name": "OLSON",
            "middle_name": "LEE",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wook Sung Kim, M.D.
• Yong Hun Kim, MD
• Yoo Jung Kim, MD
• Yoojin Kim, DO
• Brittany Carol Kimball, MD
• Erinmarie O Kimbrough, MD
• Ashley K Kimeu, NP
• David W Kimmel, M.D.
• Flora Petra Kincses, MD
• Steven James Kindel, M.D.

• Physician Assistant in Rochester, MN
• Providers in Rochester, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.