Carrie Lelania Kimball, MSN, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F404998-01 Issued in NY

Practice address

31 Plum Ave
Troy, NY 12180-5815

Phone

(267) 456-2129

NPI assigned

Jun 5, 2013

Reactivated

Aug 14, 2023

Sex

Female

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 NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St. Mary'S HealthcareGroup PAC ID 7618960709, 114 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Marys Healthcare Hospital, Amsterdam, NY, CCN 330047

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

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.

• St Marys Healthcare

  • General Acute Care Hospital
  • Amsterdam, NY
  • NPI 1518926401
  Medicare reassignment Care Compare group NPD
• St. Mary'S Healthcare

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Amsterdam, NY
  • NPI 1700636347
  NPD
• St. Mary'S Healthcare

  • Psychiatric Hospital Unit
  • Amsterdam, NY
  • NPI 1164497103
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Mary'S Healthcare

  • General Acute Care Hospital
  • Amsterdam, NY
  • NPI 1811977796
  Care Compare affiliation

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

{
    "created_epoch": "1370390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692489600000",
    "number": "1265870943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 PLUM AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121805815",
            "telephone_number": "267-456-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 PLUM AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121805815",
            "telephone_number": "267-456-2129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "CARRIE",
        "middle_name": "LELANIA",
        "name_prefix": "Ms.",
        "credential": "MSN, APRN, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-05",
        "last_updated": "2023-08-20",
        "certification_date": "2023-08-20",
        "deactivation_date": "2023-07-27",
        "reactivation_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F404998-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Kiddney-Fox
• Akie Kido
• Donald Killam
• Chong Kee Kim, M.D.
• Kia Ann Kim, MD
• Brenda A. King, MS-SLP
• Elizabeth Kluz
• Deidra Cassandra Knauth, FNP
• Sophie Knittle, BS, LAT, ATC
• Ashley Rose Knutson, FNP

• Psychiatric/Mental Health Nurse Practitioner in Troy, NY
• Providers in Troy, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

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