Kimberly D Roller, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

50121 Issued in TN

Practice address

1242 W Shipley Ferry Rd
Kingsport, TN 37663-3323

Phone

(423) 239-7300

Fax

(423) 239-7607

NPI assigned

Aug 20, 2007

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 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ultacare Medical PLLCGroup PAC ID 4789687484, 52 clinicians

State of Franklin Healthcare Associates, PLLCGroup PAC ID 2466346291, 258 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health Home health agency, Johnson City, TN, CCN 447422
• Smoky Mountain Home Health and Hospice, I N C Hospice, Newport, TN, CCN 441550
• Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017
• Indian Path Community Hospital Hospital, Kingsport, TN, CCN 440176
• Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063
• Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012
• Newport TN Opco LLC Nursing home, Newport, TN, CCN 445504
• Center on Aging and Health Nursing home, Erwin, TN, CCN 445424

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24871/brand/1/csg/1/fhir/r4
• Direct secure messaging: kimberlyroller@sofha.allscriptsdirect.net

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.

• State of Franklin Healthcare Associates PLLC

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1063459410

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Ultacare Medical PLLC

  • Family Medicine Physician
  • New Tazewell, TN
  • NPI 1225141492
  Medicare reassignment Care Compare group NPD
• Newport TN Opco LLC

  • Skilled Nursing Facility
  • Newport, TN
  • NPI 1013651272
  NPD (past)
• Wellmont Physician Services Inc

  • Internal Medicine Physician
  • Big Stone Gap, VA
  • NPI 1619095403

  Family Medicine

  NPD (past)

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

• Center on Aging and Health LLC

  • Skilled Nursing Facility
  • Erwin, TN
  • NPI 1427040211

  Nursing home

  Care Compare affiliation
• Comprehensive Home Healthcare Services LLC

  • Home Health Agency
  • Johnson City, TN
  • NPI 1942258769
  Care Compare affiliation
• Mountain States Health Alliance

  • Psychiatric Hospital Unit
  • Johnson City, TN
  • NPI 1023434339
  Care Compare affiliation
• Mountain States Health Alliance

  • Psychiatric Hospital Unit
  • Johnson City, TN
  • NPI 1962915652
  Care Compare affiliation
• Mountain States Health Alliance

  • General Acute Care Hospital
  • Johnson City, TN
  • NPI 1972606465
  Care Compare affiliation
• Mountain States Health Alliance

  • General Acute Care Hospital
  • Kingsport, TN
  • NPI 1992813240
  Care Compare affiliation
• Newport TN Opco LLC

  • Skilled Nursing Facility
  • Newport, TN
  • NPI 1013651272

  Nursing home

  Care Compare affiliation
• Smoky Mountain Home Health & Hospice, Inc

  • Community Based Hospice Care Agency
  • Newport, TN
  • NPI 1306816228
  Care Compare affiliation
• Wellmont Health System

  • General Acute Care Hospital
  • Bristol, TN
  • NPI 1124058615
  Care Compare affiliation
• Wellmont Health System

  • General Acute Care Hospital
  • Kingsport, TN
  • NPI 1487690400
  Care Compare affiliation

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1457544868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632476",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632476",
            "telephone_number": "423-239-7300",
            "fax_number": "423-239-7607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1242 W SHIPLEY FERRY RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376633323",
            "telephone_number": "423-239-7300",
            "fax_number": "423-239-7607"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "390 Kane St",
            "address_purpose": "LOCATION",
            "city": "Gate City",
            "state": "VA",
            "postal_code": "242512753",
            "country_code": "US",
            "telephone_number": "276-386-3411",
            "fax_number": "276-386-3492",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Med Tech Pkwy Ste 120",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376042631",
            "country_code": "US",
            "telephone_number": "423-794-5590",
            "fax_number": "423-794-5877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROLLER",
        "first_name": "KIMBERLY",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-20",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101244717",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "50121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1515804",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Rodgers, CRNA
• Rodney J. Watson, M.D., Mpllc
• Lauren N Rogers, FNP-BC
• Robert Rogers, MD
• Thomas Rogers, MD
• Alessandra M Romano
• Ronald F Godat DDS Ms PC
• Rebecca Ellen Roosa
• James P Root, CRNA
• Brenda Michele Rose, RDH

• Family Medicine Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; 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.

Verify at the official NPI Registry.