Individual provider Active NPI

Laura M Kimble, O.D.

  • Optometrist
  • Raleigh, NC
National Provider Identifier
1477567147
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2473 Issued in NC
Practice address
6325 Falls of Neuse Rd Ste 1
Raleigh, NC 27615-6883
Phone
(919) 876-1499
Fax
(919) 873-1926
NPI assigned
Jul 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2473 NC Primary

Addresses

Primary practice location

6325 Falls of Neuse Rd Ste 1
Raleigh, NC 27615-6883

Mailing address

12200 Lockhart LN
Raleigh, NC 27614-9405
Phone (317) 650-4210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171102001106 NC Practitioner - Optometry 4385900620 Practice locations: Raleigh, NC

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6325 Falls of Neuse Rd
Suite 1
Raleigh, NC 27615-6883
Phone (919) 876-1499

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2473NCMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1477567147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 LOCKHART LN",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276149405",
            "telephone_number": "317-650-4210",
            "fax_number": "919-873-1926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6325 FALLS OF NEUSE RD STE 1",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276156883",
            "telephone_number": "919-876-1499",
            "fax_number": "919-873-1926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBLE",
        "first_name": "LAURA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.