Gregory Allen Kimble, DO
Individual provider Active NPI Specialist · Everett, PA
NPI 1356315543 · NPPES record last updated Feb 25, 2020
Key facts
- NPI
- 1356315543
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- OS006868L (PA)
- Practice address
- 227 Hospital Dr
Suite 1
Everett, PA 15537-7019 - Phone
- (814) 623-9095
- NPI assigned
- Feb 14, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050118000213 | PA | Practitioner - Hospitalist |
9931158953 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DLP Conemaugh Physician Practices LLC | Current |
Accepting new patients | |
| Apogee Medical Group of Pennsylvania PC | Current |
Accepting new patients | |
| Apogee Medical Group of Pennsylvania PC | Current |
Accepting new patients | |
| Tyrone Hospital | Current |
Accepting new patients | |
| DLP Conemaugh Physician Practices LLC | Current | Accepting new patients | |
| Pinecroft Medical Center | Past | Accepting new patients |
Locations
15059 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254
Phone (602) 778-3601
1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740
1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540
105 Nason Dr
Roaring Spring, PA 16673
Phone (814) 224-2141
187 Hospital Dr
Tyrone, PA 16686
Phone (814) 342-2333
187 Hospital Dr
#A
Tyrone, PA 16686
Phone (814) 503-4735
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | OS006868L | PA | Yes |
Addresses
Primary practice location
227 Hospital Dr
Suite 1
Everett, PA 15537-7019
Mailing address
227 Hospital Dr
Suite 1
Everett, PA 15537-7019
Phone (814) 623-9095
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001167574 | Medicaid | PA |
Other providers in Everett, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.