Active NPI
Alexa Kimball, PA-C
- Medical Physician Assistant
- Bethlehem, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- MA065331
- 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, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 024982 | NY | MD | Psychologist |
| 6497 | TN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Campbell Clinic, PC | Physician Assistant | Current | Accepting new patients |
| Schuylkill Health System Medical Group, Inc. | Current | Accepting new patients | |
| Lehigh Valley Physician Group | Current | Accepting new patients | |
| Lehigh Valley Physician Group | Current | Accepting new patients | |
| Family Care Centers Inc | Current | Accepting new patients | |
| Campbell Clinic PC | Current | Accepting new patients | |
| Family Care Centers Inc. | Current | 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
- akimball1481036@nychhc.direct-ci.com
- alexa.kimball.1@1366.direct.athenahealth.com
- 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.
-
dba Lehigh Valley Physician Group - Pocono
- Internal Medicine Physician
- E Stroudsburg, PA
- NPI 1669563037
-
dba Lehigh Valley Physician Group-Hazleton
- Internal Medicine Physician
- Hazleton, PA
- NPI 1952464638
-
dba LVPG Developmental Pediatrics
- Developmental - Behavioral Pediatrics Physician
- Allentown, PA
- NPI 1780155689
-
dba Lehigh Valley Physician Group-Schuylkill
- Internal Medicine Physician
- Pottsville, PA
- NPI 1588603567
-
dba LVPG ExpressCare Pocono
- Family Medicine Physician
- East Stroudsburg, PA
- NPI 1316409626
-
dba LVPG Family and Internal Medicine - East Stroudsburg
- Family Medicine Physician
- East Stroudsburg, PA
- NPI 1245093368
-
dba Childrens Clinic at LVH
- Pediatrics Physician
- Allentown, PA
- NPI 1285893545
-
dba LVPG ExpressCare Schuylkill
- Emergency Medicine Physician
- Pottsville, PA
- NPI 1063073823
-
- Durable Medical Equipment & Medical Supplies
- Carthage, TN
- NPI 1669366068
-
dba Campbell Clinic MRI
- Magnetic Resonance Imaging (MRI) Clinic/Center
- Germantown, TN
- NPI 1588619944
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Allentown, PA
- NPI 1164400131
-
- Psychiatric Hospital Unit
- Bethlehem, PA
- NPI 1609834001
-
- Children's Hospital
- Allentown, PA
- NPI 1952954307
-
dba Bristol Regional Medical Center
- General Acute Care Hospital
- Bristol, TN
- NPI 1124058615
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.