NPIMap

Individual provider Active NPI

Joseph Carr Kimbell, D.O.

  • Family Medicine Physician
  • Byron, IL
National Provider Identifier
1386084259
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036141869 Issued in IL
Practice address
230 W. Blackhawk Blvd.
Byron, IL 61010
Phone
(779) 696-1300
Fax
(815) 234-2314
NPI assigned
Jun 25, 2013
Last updated
Mar 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 5101020749 MI
Family Medicine Physician 207Q00000X 036141869 IL Primary

Addresses

Primary practice location

230 W. Blackhawk Blvd.
Byron, IL 61010

Mailing address

PO Box 78866
Milwaukee, WI 53278-8866
Phone (779) 696-1750

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jkimbelldo914257@direct.uwhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161117000646 IL Practitioner - Family Practice 9830495589 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedishamerican HospitalGroup PAC ID 5799698346, 386 clinicians

Practice addresses (Care Compare)

230 W Blackhawk Dr
Sa Byron
Byron, IL 61010-8988
Phone (779) 696-1300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.51 of 100Reported as group
Quality
83.2
Promoting interoperability
77
Improvement activities
40
Cost
71.7

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036141869ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedishamerican Hospital Family Medicine CurrentSince Dec 1, 2016 Accepting new patients
Swedishamerican Hospital CurrentSince Dec 1, 2016 Accepting new patients
Swedishamerican Hospital Family Medicine Current Accepting new patients

Locations

230 W Blackhawk Dr
Byron, IL 61010
Phone (779) 696-1300

2550 Charles St
Rockford, IL 61108
Phone (779) 696-7285

6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610

Interoperability endpoints

  • Direct secure messaging: jkimbelldo914257@direct.uwhealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1386084259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78866",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532788866",
            "telephone_number": "779-696-1750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W. BLACKHAWK BLVD.",
            "city": "BYRON",
            "state": "IL",
            "postal_code": "61010",
            "telephone_number": "779-696-1300",
            "fax_number": "815-234-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBELL",
        "first_name": "JOSEPH",
        "middle_name": "CARR",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-25",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "5101020749",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036141869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkimbelldo914257@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "230 W. Blackhawk Blvd.",
            "city": "Byron",
            "state": "IL",
            "country_code": "US",
            "postal_code": "61010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Byron, IL

Sources for this page

Verify at the official NPI Registry.