Nicole Athena Kimball, MS PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1877 Issued in MT

Practice address

1313 W Park Street
Suite # 7
Livingston, MT 59047

Phone

(406) 222-5519

Fax

(406) 222-0366

NPI assigned

Dec 8, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Excel Orthopedic Physical Therapy Limited PartnershipGroup PAC ID 7416332549, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Excel Orthopedic Physical Therapy Limited Partnership

  • Physical Therapist
  • Bozeman, MT
  • NPI 1700518057
  Medicare reassignment Care Compare group NPD
• Yellowstone Physical Therapy Inc.

  • Physical Therapy Clinic/Center
  • Livingston, MT
  • NPI 1841322310

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437218856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 N 3RD",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "59715",
            "telephone_number": "406-570-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 W PARK STREET",
            "address_2": "SUITE # 7",
            "city": "LIVINGSTON",
            "state": "MT",
            "postal_code": "59047",
            "telephone_number": "406-222-5519",
            "fax_number": "406-222-0366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "NICOLE",
        "middle_name": "ATHENA",
        "name_prefix": "Ms.",
        "credential": "MS PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "1877",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0193081",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3400826",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00122746",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "60503",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MT STATE FUND",
            "identifier": "MSF1250520",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• KCS Western Drug Inc (Western Drug of Livingston)
• Nicole Kelley, FNP
• Carla Kent, LAC
• Victoria F. Kenyon, LCSW
• Kim Salloux Lac
• Lexi Jade Klawitter, DPT
• Mark Klawitter, R.PH.
• Piper D Kmetz
• Joel Foster Knox, LAC
• Jill Diane Kordonowy, COTA

• Physical Therapist in Livingston, MT
• Providers in Livingston, MT by specialty
• Physical Therapist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.