NPIMap

Individual provider Active NPI

Alexa Dorothy Kimball, CRNA

  • Certified Registered Nurse Anesthetist
  • Clackamas, OR
National Provider Identifier
1457099707
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
10056028 Issued in OR
Practice address
10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone
(800) 813-2000
NPI assigned
May 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 10056028 OR Primary

Addresses

Primary practice location

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970

Mailing address

500 NE Multnomah St Ste 100
Portland, OR 97232-2099
Phone (800) 813-2000

Other practice location 1

7 Independence Pt Ste 300
Greenville, SC 29615-4569
Phone (864) 522-3700

Other practice location 2

701 Grove Rd
Greenville, SC 29605-4210
Phone (864) 455-7000

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220824003350 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 0840674842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7 Independence PT
Suite 300
Greenville, SC 29615-4569
Phone (864) 522-3700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26117SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jul 11, 2022 Accepting new patients
Prisma Health University Medical Group CurrentSince Jul 11, 2022 Accepting new patients
Prisma Health University Medical Group Current Accepting new patients

Locations

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

67 Creekside Park Ct
Greenville, SC 29615
Phone (864) 242-4602

7 Independence Pt
Ste 300
Greenville, SC 29615
Phone (864) 522-3700

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

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.

Hospital & facility affiliations 43

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1457099707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NE MULTNOMAH ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322099",
            "telephone_number": "800-813-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10180 SE SUNNYSIDE RD",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970158970",
            "telephone_number": "800-813-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7 Independence Pt Ste 300",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296154569",
            "country_code": "US",
            "telephone_number": "864-522-3700",
            "fax_number": "864-522-3705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296054210",
            "country_code": "US",
            "telephone_number": "864-455-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "ALEXA",
        "middle_name": "DOROTHY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-26",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "10056028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; 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.