Jimmy Ray Kimball Jr., CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

164911 Issued in NC

Practice address

3000 New Bern Ave
Raleigh, NC 27610-1231

Phone

(919) 350-5645

NPI assigned

Jan 31, 2007

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

Enrolled in NC

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Triad Sedation Associates LLCGroup PAC ID 4587903448, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Triad Sedation Associates, LLC

  • Certified Registered Nurse Anesthetist
  • Winston Salem, NC
  • NPI 1427528595

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Nash Hospitals Inc

  • Certified Registered Nurse Anesthetist
  • Rocky Mount, NC
  • NPI 1003881822

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Nash Hospitals Inc

  • Land Ambulance
  • Rocky Mount, NC
  • NPI 1275374290
  NPD
• Anesthesia Resources of the Carolinas, P.a.

  • Pain Medicine (Anesthesiology) Physician
  • Dunn, NC
  • NPI 1336185974
  NPD (past)
• East Carolina Anesthesia Associates, PLLC

  • Anesthesiology Physician
  • Greenville, NC
  • NPI 1205996519

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Perioperative Medicine Consultants, LLC

  • Pain Medicine (Anesthesiology) Physician
  • Mullins, SC
  • NPI 1598850257
  NPD (past)

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1346387339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18139",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276198139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101231",
            "telephone_number": "919-350-5645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "JIMMY",
        "middle_name": "RAY",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "164911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8052459",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD-MEDICARE",
            "identifier": "P00293527",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Seulah Kim, DMD
• Seung W. Kim, M.D.
• Yejin Kim, AGNP
• Annemary Mucuvi Kimani, PMHNP
• Janice Louise Kimball, NP
• Kimberley Cochran PLLC
• Sarah Elizabeth Kimberlin, FNP-C
• Kimberly Home
• Kimberly Pittman, PLLC
• Dana H Kimberly, OTR/L

• Certified Registered Nurse Anesthetist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Certified Registered Nurse Anesthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.