Organization Active NPI

Ronald W Kimball M D P C

  • Ophthalmology Physician
  • Philadelphia, PA
National Provider Identifier
1467627711
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD015251E Issued in PA
Legal business name
RONALD W KIMBALL M D P C
Practice address
7701 Lindbergh Blvd
Suite 713
Philadelphia, PA 19153-2132
Phone
(215) 365-1113
Fax
(215) 365-1114
NPI assigned
Apr 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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

Authorized official

Name
Ronald W Kimball, M.D.NPI 1407825482
Title
President
Phone
(215) 365-1113

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X MD015251E PA Primary

Addresses

Primary practice location

7701 Lindbergh Blvd
Suite 713
Philadelphia, PA 19153-2132

Mailing address

1 Wingate CT
Flourtown, PA 19031-1117
Phone (215) 365-1113

Other identifiers 1

IdentifierTypeStateIssuer
00065287900001MedicaidPA

National Provider Directory

National Provider Directory

Locations

7701 Lindbergh Blvd
Ste 713
Philadelphia, PA 19153
Phone (215) 365-1113

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288137600000",
    "number": "1467627711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WINGATE CT",
            "city": "FLOURTOWN",
            "state": "PA",
            "postal_code": "190311117",
            "telephone_number": "215-365-1113",
            "fax_number": "215-365-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7701 LINDBERGH BLVD",
            "address_2": "SUITE 713",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191532132",
            "telephone_number": "215-365-1113",
            "fax_number": "215-365-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD W KIMBALL M D P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-28",
        "last_updated": "2010-10-27",
        "status": "A",
        "authorized_official_last_name": "KIMBALL",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-365-1113",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD015251E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00065287900001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; 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.