Active NPI
Tim Allen Kimbrell, M.D.
- Psychiatry Physician
- North Little Rock, AR
National Provider Identifier
1265521249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- C-7938
- Practice address
- 2200 Fort Roots Drive
BLDG 170 Unit 2H
North Little Rock, AR 72114 - Phone
- (501) 257-3468
- Fax
- (501) 257-3125
- NPI assigned
- Oct 11, 2006
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | C-7938 | AR | Primary |
Addresses
Primary practice location
2200 Fort Roots Drive
BLDG 170 Unit 2H
North Little Rock, AR 72114
Mailing address
2200 Fort Roots Dr
BLDG 170 Unit 2H
North Little Rock, AR 72114-1709
Phone (501) 257-3468
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C-7938 | AR | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1265521249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 FORT ROOTS DR",
"address_2": "BLDG 170 UNIT 2H",
"city": "NORTH LITTLE ROCK",
"state": "AR",
"postal_code": "721141709",
"telephone_number": "501-257-3468",
"fax_number": "501-257-3125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 FORT ROOTS DRIVE",
"address_2": "BLDG 170 UNIT 2H",
"city": "NORTH LITTLE ROCK",
"state": "AR",
"postal_code": "72114",
"telephone_number": "501-257-3468",
"fax_number": "501-257-3125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMBRELL",
"first_name": "TIM",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "AR",
"license": "C-7938",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in North Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.