Active NPI
Tyler Neil Kimble
- Internal Medicine Physician
- Louisville, KY
National Provider Identifier
1407571482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 62051
- Practice address
- 1 Audubon Plaza Dr
Louisville, KY 40217-1318 - Phone
- (502) 636-7111
- NPI assigned
- Oct 11, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 62051 | KY | Primary |
Addresses
Primary practice location
1 Audubon Plaza Dr
Louisville, KY 40217-1318
Mailing address
1 Audubon Plaza Dr
Louisville, KY 40217-1318
Other names 1
- Tyler Neil Ellison
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
500 W Berkeley St
Uniontown, PA 15401-5514
Phone (724) 430-6899
Hospital & facility affiliations
- Uniontown Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fayette Physician Network Inc | Internal Medicine | Current | Accepting new patients |
| Fayette Physician Network Inc | Current | Accepting new patients |
Locations
500 W Berkeley St
Uniontown, PA 15401
Phone (724) 430-5000
201 Mary Higginson Ln
Uniontown, PA 15401
Phone (724) 430-5940
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Friendsville, MD
- NPI 1437823044
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Uniontown, PA
- NPI 1861409773
-
- General Acute Care Hospital
- Uniontown, PA
- NPI 1871594127
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783382400000",
"number": "1407571482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 AUDUBON PLAZA DR",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402171318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 AUDUBON PLAZA DR",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402171318",
"telephone_number": "502-636-7111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMBLE",
"first_name": "TYLER",
"middle_name": "NEIL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-11",
"last_updated": "2026-07-07",
"certification_date": "2026-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "KY",
"license": "62051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TYLER",
"last_name": "ELLISON",
"middle_name": "NEIL",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.