NPIMap

Individual provider Active NPI

Tim L Kynion, PAC

  • Physician Assistant
  • Monte Vista, CO
National Provider Identifier
1386708501
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0002767 Issued in CO
Practice address
1033 2ND Ave
Monte Vista, CO 81144-1737
Phone
(719) 852-8827
NPI assigned
Dec 21, 2006
Last updated
Sep 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0002767 CO Primary

Addresses

Primary practice location

1033 2ND Ave
Monte Vista, CO 81144-1737

Mailing address

1033 2ND Ave
Monte Vista, CO 81144-1737
Phone (719) 852-8827

Other identifiers 1

IdentifierTypeStateIssuer
9000180888MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130513000432 NE Practitioner - Physician Assistant 8022018340 Reassigns benefits to 6 organizations
I20220817004012 CO Practitioner - Physician Assistant 8022018340 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kimball County HospitalGroup PAC ID 5799751004, shared by 4 NPIs, 19 clinicians

Practice addresses (Care Compare)

1033 2ND Ave
Monte Vista, CO 81144-1737
Phone (719) 852-8827

255 W 4TH St
Kimball, NE 69145-1706
Phone (308) 235-1951

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1715NEMDSpeech-Language Pathologist
50-001387OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wray Community District Hospital CurrentSince Dec 1, 2022 Accepting new patients
Kimball County Hospital CurrentSince Jan 13, 2026 Accepting new patients
Kimball County Hospital CurrentSince Oct 30, 2025 Accepting new patients
Ogallala Community Hospital CurrentSince Apr 1, 2013 Accepting new patients
Harlan County Health System Physician Assistant CurrentSince Nov 10, 2021 Accepting new patients
Kimball County Hospital CurrentSince Oct 30, 2025 Accepting new patients
Ogallala Community Hospital CurrentSince Apr 1, 2013 Accepting new patients
Wray Community District Hospital CurrentSince Dec 1, 2022 Accepting new patients
Garden County Hospital & Nursing Home CurrentSince Jul 1, 2024 Accepting new patients
Ross Emergency Group PC, Inc Physician Assistant Past Accepting new patients

Locations

1017 W 7th St
Wray, CO 80758
Phone (970) 332-4811

700 Main St
Wray, CO 80758
Phone (970) 332-3450

717 Brown St
Alma, NE 68920
Phone (308) 928-2151

255 W 4th St
Kimball, NE 69145
Phone (308) 235-1951

2601 N Spruce St
Ogallala, NE 69153
Phone (308) 284-3645

2601 N Spruce St
#A
Ogallala, NE 69153
Phone (308) 284-4011

1100 W 2nd St
Oshkosh, NE 69154
Phone (308) 772-3283

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/ntTIZxOIDS2tB2PUqr33FYQo0UWd2W9R/
  • Direct secure messaging: tim.kynion.1@14566.direct.athenahealth.com
  • Direct secure messaging: tim.kynionen.p1@direct.rwgcrhc.nextgenshare.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 7

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": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1386708501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 2ND AVE",
            "city": "MONTE VISTA",
            "state": "CO",
            "postal_code": "811441737",
            "telephone_number": "719-852-8827",
            "fax_number": "719-852-2739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 2ND AVE",
            "city": "MONTE VISTA",
            "state": "CO",
            "postal_code": "811441737",
            "telephone_number": "719-852-8827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYNION",
        "first_name": "TIM",
        "middle_name": "L",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0002767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000180888",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monte Vista, CO

Sources for this page

Verify at the official NPI Registry.