Individual provider Active NPI

Kimberlea A Roe, MD

  • Specialist
  • Dallas, TX
National Provider Identifier
1306890694
Registry record updated Jan 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
K2112 Issued in TX
Practice address
8160 Walnut Hill LN
Ste 304
Dallas, TX 75231-4339
Phone
(214) 369-2895
NPI assigned
May 20, 2006
Last updated
Jan 22, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X K2112 TX Primary

Addresses

Primary practice location

8160 Walnut Hill LN
Ste 304
Dallas, TX 75231-4339

Mailing address

8160 Walnut Hill LN
Ste 304
Dallas, TX 75231-4339
Phone (214) 369-2895

Other identifiers 1

IdentifierTypeStateIssuer
89380SOtherTXBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120926000743 TX Practitioner - Obstetrics/Gynecology 3375792872 Reassigns benefits to 1 organization
I20230410002631 NM Practitioner - Obstetrics/Gynecology 3375792872 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
K2112TXMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Mar 27, 2023 Accepting new patients
Presbyterian Healthcare Services CurrentSince Mar 27, 2023 Accepting new patients
Tracy E Speight MD PA Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
GYN Healthcare Associates Past Accepting new patients
Texas Health Presbyterian Hospital Plano Past Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients

Locations

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

4801 Beckner Rd
Santa Fe, NM 87507
Phone (505) 772-1234

Interoperability endpoints

  • FHIR API: https://epproxy.texashealth.org/FHIR/api/FHIR/DSTU2/
  • Direct secure messaging: kroe227662@direct.phs.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200960000000",
    "number": "1306890694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8160 WALNUT HILL LN",
            "address_2": "STE 304",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314339",
            "telephone_number": "214-369-2895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8160 WALNUT HILL LN",
            "address_2": "STE 304",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314339",
            "telephone_number": "214-369-2895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROE",
        "first_name": "KIMBERLEA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2008-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "K2112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "89380S",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.