Individual provider Active NPI

Lloyd Lee Kimzey Jr., PHD

  • Clinical Psychologist
  • North Platte, NE
National Provider Identifier
1396777884
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
208 Issued in NE
Practice address
220 W Leota St
Suite 200
North Platte, NE 69101-6293
Phone
(308) 534-4872
Fax
(308) 534-5653
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 208 NE Primary

Addresses

Primary practice location

220 W Leota St
Suite 200
North Platte, NE 69101-6293

Mailing address

220 W Leota St
Suite 200
North Platte, NE 69101-6293
Phone (308) 534-4872

Other identifiers 3

IdentifierTypeStateIssuer
8264OtherBCBS DIRECT PROVIDER
5107OtherMIDLANDS CHOICE
96018OtherBCBS AUXILLIARY PROVIDER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070219000645 NE Practitioner - Clinical Psychologist 5496857633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Behavioral Medicine Associates LLCGroup PAC ID 9032110705, 2 clinicians

Practice addresses (Care Compare)

306 W 4TH St
North Platle, NE 69101-3828
Phone (308) 534-4872

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
208NEMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Region II Human Services Past Accepting new patients
North Platte Nebraska Hospital Corporation Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1396777884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 W LEOTA ST",
            "address_2": "SUITE 200",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691016293",
            "telephone_number": "308-534-4872",
            "fax_number": "308-534-5653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W LEOTA ST",
            "address_2": "SUITE 200",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691016293",
            "telephone_number": "308-534-4872",
            "fax_number": "308-534-5653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMZEY",
        "first_name": "LLOYD",
        "middle_name": "LEE",
        "name_prefix": "Miss",
        "name_suffix": "Jr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NE",
            "license": "208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS DIRECT PROVIDER",
            "identifier": "8264",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "5107",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AUXILLIARY PROVIDER",
            "identifier": "96018",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Platte, NE

Sources for this page

Verify at the official NPI Registry.