Individual provider Active NPI

Alexa Kimball, PA-C

  • Medical Physician Assistant
  • Bethlehem, PA
National Provider Identifier
1386249712
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA065331 Issued in PA
Practice address
325 W Broad St FL 3
Bethlehem, PA 18018-5526
Phone
(484) 626-9250
NPI assigned
Dec 3, 2020
Last updated
Apr 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 024982 NY
Medical Physician Assistant 363AM0700X MA065331 PA Primary

Addresses

Primary practice location

325 W Broad St FL 3
Bethlehem, PA 18018-5526

Mailing address

2100 Mack Blvd FL 4
Allentown, PA 18103-5622
Phone (484) 884-4500

Other practice location 1

82-68 164th Street
Jamaica, NY 11432
Phone (718) 883-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240415002132 PA Practitioner - Physician Assistant 8729427455 Reassigns benefits to 4 organizations
I20250801000799 TN Practitioner - Physician Assistant 8729427455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Campbell Clinic, PCGroup PAC ID 9638082076, 229 clinicians

Practice addresses (Care Compare)

1 Medical Park Blvd
Suite 300E
Bristol, TN 37620-7497
Phone (423) 434-6300

1400 S Germantown Rd
Germantown, TN 38138-2205
Phone (901) 759-3100

3 Professional Park Dr
Johnson City, TN 37604-6529
Phone (423) 434-6300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
024982NYMDPsychologist
6497TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Campbell Clinic, PC Physician Assistant CurrentSince Aug 4, 2025 Accepting new patients
Schuylkill Health System Medical Group, Inc. CurrentSince Apr 15, 2024 Accepting new patients
Lehigh Valley Physician Group CurrentSince Apr 1, 2024 Accepting new patients
Lehigh Valley Physician Group CurrentSince Apr 1, 2024 Accepting new patients
Family Care Centers Inc CurrentSince Apr 15, 2024 Accepting new patients
Campbell Clinic PC CurrentSince Aug 4, 2025 Accepting new patients
Family Care Centers Inc. CurrentSince Apr 15, 2024 Accepting new patients
Campbell Clinic Past Accepting new patients

Locations

2100 Mack Blvd
Fl 4
Allentown, PA 18103

325 W Broad St
Fl 3
Bethlehem, PA 18018
Phone (484) 626-9250

500 Plaza Ct
East Stroudsburg, PA 18301
Phone (570) 426-2330

700 Schuylkill Manor Rd
Ste 3
Pottsville, PA 17901
Phone (570) 621-4440

320 W Pumping Station Rd
Quakertown, PA 18951
Phone (215) 529-4240

1 Medical Park Blvd
Ste 300E
Bristol, TN 37620
Phone (423) 245-3161

105 Meadow View Rd
Ste 4
Bristol, TN 37620
Phone (423) 844-6935

1500 W Elk Ave
Ste 102
Elizabethton, TN 37643
Phone (423) 282-5054

3 Professional Park Dr
Ste 10
Johnson City, TN 37604
Phone (423) 926-4331

3 Professional Park Dr
Ste 21
Johnson City, TN 37604

1400 S Germantown Rd
Memphis, TN 38138
Phone (901) 759-3111

16000 Johnston Memorial Dr
Ste 100
Abingdon, VA 24211
Phone (276) 258-1760

Interoperability endpoints

  • Direct secure messaging: akimball1481036@nychhc.direct-ci.com
  • Direct secure messaging: alexa.kimball.1@1366.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/1366/brand/1/csg/1/fhir/r4

Organizations & group practices 11

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": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1386249712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 4",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622",
            "telephone_number": "484-884-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W BROAD ST FL 3",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180185526",
            "telephone_number": "484-626-9250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "82-68 164th Street",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "11432",
            "country_code": "US",
            "telephone_number": "718-883-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "ALEXA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-03",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "024982",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA065331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.