Jimmy Clarke Kimball, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

13576 Issued in TN

Practice address

4600 Asheville Hwy
Knoxville, TN 37914-3665

Phone

(865) 522-8114

Fax

(866) 550-6541

NPI assigned

Sep 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1316040926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15004",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379015004",
            "telephone_number": "865-541-8895",
            "fax_number": "865-633-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 ASHEVILLE HWY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379143665",
            "telephone_number": "865-522-8114",
            "fax_number": "866-550-6541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "JIMMY",
        "middle_name": "CLARKE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "13576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q007841",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD PROVIDER ID",
            "identifier": "6165200",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sieon Kim, AUD
• Stella Kim, DDS
• Tomoko Kim, DSCPT
• Cathy Kimball, N.P.
• Jessica Brush Kimball
• Kristopher J. Kimball, MD
• Gaige Tycean Kimbell
• Erin Groh Kimble, PA-C
• James R. Kimble, M.D.
• Joshua J Kimrey, D.D.S.

• Pediatrics Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; 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.