Rebecca Elaine Kimbell, MSN, APRN, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2013009202 Issued in MO

Practice address

801 Kidwell Dr
Versailles, MO 65084-1787

Phone

(573) 378-5454

Fax

(573) 378-5055

NPI assigned

Jul 14, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Mrs. Rebecca Elaine Kimbell-Farris Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Master of Science - Nursing

State licenses

Practice roles

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.

• Mercy Health Services Inc.

  • Medical Specialty Clinic/Center
  • Yukon, OK
  • NPI 1255398251
  NPD (past)

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1427212976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 KIDWELL DR",
            "city": "VERSAILLES",
            "state": "MO",
            "postal_code": "650841787",
            "telephone_number": "573-378-5454",
            "fax_number": "573-378-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 KIDWELL DR",
            "city": "VERSAILLES",
            "state": "MO",
            "postal_code": "650841787",
            "telephone_number": "573-378-5454",
            "fax_number": "573-378-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBELL",
        "first_name": "REBECCA",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "credential": "MSN, APRN, CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-14",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "0063706",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2013009202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427212976",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "135570059",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200205320A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "KIMBELL-FARRIS",
            "middle_name": "ELAINE",
            "prefix": "MRS.",
            "credential": "MSN, APRN, CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• JRS Enterprises II Missouri LLC
• JRS Enterprises II Missouri LLC
• Ashley Joann Judd, LPN
• Kevin K.E. Carl, O.D. Dba Eye Clinic
• Kidwell Home
• Julie Kisner, LCSW
• Mary Kloeppel
• Sunshine Lafoy
• Laurie Pharmacy Inc
• Sylvia Lawson-Cook, LCSW

• Family Nurse Practitioner in Versailles, MO
• Providers in Versailles, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.