Active NPI
Gretchen Kimble, OT
- Occupational Therapist
- Las Cruces, NM
National Provider Identifier
1427306448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3827
- Practice address
- 1681 Hickory Loop
Las Cruces, NM 88005-6502 - Phone
- (575) 652-3155
- NPI assigned
- Aug 23, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 110337 | TX | |
| Occupational Therapist | 225X00000X | 3827 | NM | Primary |
Addresses
Primary practice location
1681 Hickory Loop
Las Cruces, NM 88005-6502
Mailing address
6729 Southwind Dr
El Paso, TX 79912-3238
Phone (915) 355-2494
Other practice location 1
4400 N Mesa St Ste 4
El Paso, TX 79902-1147
Phone (915) 351-1600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110337 | TX | MD | Case Manager/Care Coordinator |
| 3827 | NM | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jggpo Corporation | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- El Paso, TX
- NPI 1932469012
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1427306448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6729 SOUTHWIND DR",
"city": "EL PASO",
"state": "TX",
"postal_code": "799123238",
"telephone_number": "915-355-2494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1681 HICKORY LOOP",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880056502",
"telephone_number": "575-652-3155"
}
],
"practiceLocations": [
{
"address_1": "4400 N Mesa St Ste 4",
"address_purpose": "LOCATION",
"city": "El Paso",
"state": "TX",
"postal_code": "799021147",
"country_code": "US",
"telephone_number": "915-351-1600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIMBLE",
"first_name": "GRETCHEN",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-23",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "TX",
"license": "110337",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NM",
"license": "3827",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.