Individual provider Active NPI

Kimberly Sumbler

  • Family Nurse Practitioner
  • Alexandria, LA
National Provider Identifier
1497200158
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP08980 Issued in LA
Practice address
3000 S Macarthur Dr
Alexandria, LA 71301-2927
Phone
(318) 448-6800
Fax
(318) 448-6999
NPI assigned
Aug 23, 2016
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP08980 LA Primary

Addresses

Primary practice location

3000 S Macarthur Dr
Alexandria, LA 71301-2927

Mailing address

3000 S Macarthur Dr
Alexandria, LA 71301-2927
Phone (318) 448-6800

Other identifiers 1

IdentifierTypeStateIssuer
2449150MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170621002199 LA Practitioner - Nurse Practitioner 7214205996 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Dec 1, 2020 Accepting new patients
C H Wilkinson Physician Network CurrentSince May 16, 2017 Accepting new patients
Earl Sumbler Memorial Healthcare Center Family CurrentSince Jul 26, 2022 Accepting new patients
C H Wilkinson Physician Network CurrentSince May 16, 2017 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Dec 1, 2020 Accepting new patients

Locations

2716 Lee St
Alexandria, LA 71301
Phone (318) 229-2215

3000 S MacArthur Dr
Alexandria, LA 71301
Phone (318) 448-6800

3351 Masonic Dr
Alexandria, LA 71301
Phone (318) 448-6800

1 Saint Mary Pl
Shreveport, LA 71101
Phone (318) 681-4500

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25424/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1471910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1497200158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 S MACARTHUR DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713012927",
            "telephone_number": "318-448-6800",
            "fax_number": "318-448-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 S MACARTHUR DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713012927",
            "telephone_number": "318-448-6800",
            "fax_number": "318-448-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMBLER",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP08980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2449150",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

Verify at the official NPI Registry.