Individual provider Active NPI

Jana Kimberlin, FNP

  • Family Nurse Practitioner
  • College Station, TX
National Provider Identifier
1396126116
Registry record updated Nov 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
764222 Issued in TX
Practice address
4421 Highway 6 S Ste 100
College Station, TX 77845-6176
Phone
(979) 731-5200
Fax
(979) 731-5210
NPI assigned
Jun 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 764222 TX Primary

Addresses

Primary practice location

4421 Highway 6 S Ste 100
College Station, TX 77845-6176

Mailing address

1500 University Dr E
#100
College Station, TX 77840-2600
Phone (979) 846-1100

Other practice location 1

1500 University Dr E
#100
College Station, TX 77840-2600
Phone (979) 846-1100

Other names 1

  • Jana Lawrence Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20161228001929 TX Practitioner - Nurse Practitioner 1355647041 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph Regional Health CenterGroup PAC ID 5294727921, 141 clinicians

Practice addresses (Care Compare)

2210 E 29TH St
Bryan, TX 77802-1903
Phone (979) 821-6300

2801 Franciscan Dr
Bryan, TX 77802-2544
Phone (979) 776-2401

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
764222TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Regional Health Center Family CurrentSince Jan 9, 2017 Accepting new patients
St Joseph Regional Health Center CurrentSince Jan 9, 2017 Accepting new patients
College Station Hospital LP Past Accepting new patients

Locations

2210 E 29th St
Bryan, TX 77802
Phone (979) 821-6300

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

4421 State Highway 6 S
Ste 100
College Station, TX 77845
Phone (979) 731-5200

Interoperability endpoints

  • Direct secure messaging: jkimberlin457228@direct.stlukeshealth.org
  • Direct secure messaging: jana.kimberlin@sjrhc.eclinicaldirectplus.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1396126116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 UNIVERSITY DR E",
            "address_2": "#100",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778402600",
            "telephone_number": "979-846-1100",
            "fax_number": "979-260-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4421 HIGHWAY 6 S STE 100",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778456176",
            "telephone_number": "979-731-5200",
            "fax_number": "979-731-5210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 University Dr E",
            "address_2": "#100",
            "address_purpose": "LOCATION",
            "city": "College Station",
            "state": "TX",
            "postal_code": "778402600",
            "country_code": "US",
            "telephone_number": "979-846-1100",
            "fax_number": "979-260-9390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMBERLIN",
        "first_name": "JANA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-17",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "764222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANA",
            "last_name": "LAWRENCE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in College Station, TX

Sources for this page

Verify at the official NPI Registry.