Active NPI
Ronald Lee Kimball, PHD
- Psychologist
- Silver Spring, MD
National Provider Identifier
1356433734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 00775
- Practice address
- 4 Burket CT
Silver Spring, MD 20910-1355 - Phone
- (202) 452-6257
- Fax
- (301) 608-2624
- NPI assigned
- Sep 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY886 | DC | |
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | PSY886 | DC | |
| Forensic Psychologist | 103TF0200X | PSY886 | DC | |
| Group Psychotherapy Psychologist | 103TP2701X | PSY886 | DC | |
| Psychologist | 103T00000X | 00775 | MD | Primary |
Addresses
Primary practice location
4 Burket CT
Silver Spring, MD 20910-1355
Mailing address
4 Burket CT
Silver Spring, MD 20910-1355
Phone (202) 452-6257
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY886 | DC | MD | Psychologist |
| 00775 | MD | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Randy Beck Thurman, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Social Worker
- Washington, DC
- NPI 1255622411
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598832000000",
"number": "1356433734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 BURKET CT",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209101355",
"telephone_number": "202-452-6257",
"fax_number": "301-608-2624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 BURKET CT",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209101355",
"telephone_number": "202-452-6257",
"fax_number": "301-608-2624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMBALL",
"first_name": "RONALD",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-29",
"last_updated": "2020-08-31",
"certification_date": "2020-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "DC",
"license": "PSY886",
"primary": false
},
{
"code": "103TA0400X",
"taxonomy_group": "",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": "DC",
"license": "PSY886",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "DC",
"license": "PSY886",
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "DC",
"license": "PSY886",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "00775",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Silver Spring, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.