Crystal Noel Kimball, FNP, RN

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

95024333 Issued in CA

Practice address

1050 N State St
Ukiah, CA 95482-3414

Phone

(707) 662-3111

NPI assigned

Feb 24, 2023

Sex

Female

Sole proprietor

No

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 CA

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ukiah Adventist HospitalGroup PAC ID 6406816123, shared by 5 NPIs, 136 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Home Care Services Home health agency, Willits, CA, CCN 557283
• Adventist Health Ukiah Valley Hospital, Ukiah, CA, CCN 050301
• Adventist Health Howard Memorial Hospital, Willits, CA, CCN 051310
• Adventist Health Clearlake Hospital, Clearlake, CA, CCN 051317

Merit-based Incentive Payment System (MIPS)

Final score

89.41 of 100Reported as group

Quality

86.32

Promoting interoperability

95

Improvement activities

40

Cost

66.55

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

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.

• Adventist Health Physicians Network

  • Multi-Specialty Clinic/Center
  • Hanford, CA
  • NPI 1063718583
  Medicare reassignment NPD
• Adventist Health Physicians Network

  • Physical Therapy Clinic/Center
  • Paradise, CA
  • NPI 1134092190
  NPD
• Adventist Health Physicians Network

  • Pediatrics Physician
  • Ukiah, CA
  • NPI 1184175895
  NPD

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

• Adventist Health Clearlake Hospital Inc.

  • Critical Access Hospital
  • Clearlake, CA
  • NPI 1124018031
  Care Compare affiliation
• Ukiah Adventist Hospital

  • General Acute Care Hospital
  • Ukiah, CA
  • NPI 1235120676
  Care Compare affiliation
• Western Health Resources

  • Home Health Agency
  • Willits, CA
  • NPI 1467630764
  Care Compare affiliation
• Willits Hospital Inc.

  • Critical Access Hospital
  • Willits, CA
  • NPI 1356339543
  Care Compare affiliation

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

{
    "created_epoch": "1677196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1316646797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 SANEL DR",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954829604",
            "telephone_number": "530-601-0314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 N STATE ST",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954823414",
            "telephone_number": "707-662-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "CRYSTAL",
        "middle_name": "NOEL",
        "name_prefix": "Mrs.",
        "credential": "FNP, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-24",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95024333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Eugene Kilkenny Jr., MD
• Thomas Killebrew
• Jiyoung Kim, R.PH.
• Sang Min Kim
• Valerie Kim
• Nicole Kimball, PA-C, CAQ-OBGYN
• Joseph R Kimbro, MD
• Michelle L King
• Chandra Kingston
• Joy Carla Kinion

• Primary Care Nurse Practitioner in Ukiah, CA
• Providers in Ukiah, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.