Individual provider Active NPI

Keith Kimbrell, M.D.

  • Diagnostic Radiology Physician
  • Nashville, TN
National Provider Identifier
1528045879
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD015678 Issued in TN
Practice address
210 25TH Ave N Ste 1204
Nashville, TN 37203-1620
Phone
(615) 312-0600
Fax
(615) 320-3259
NPI assigned
Dec 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD015678 TN Primary

Addresses

Primary practice location

210 25TH Ave N Ste 1204
Nashville, TN 37203-1620

Mailing address

210 25TH Ave N Ste 1204
Nashville, TN 37203-1620
Phone (615) 312-0600

Other identifiers 3

IdentifierTypeStateIssuer
7100493620MedicaidKY
1510208MedicaidTN
338633AMedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15678TNMDSocial Worker
MD015678TNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radcare of Tennessee PC Diagnostic Radiology Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1528045879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 25TH AVE N STE 1204",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031620",
            "telephone_number": "615-312-0600",
            "fax_number": "615-320-3259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 25TH AVE N STE 1204",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031620",
            "telephone_number": "615-312-0600",
            "fax_number": "615-320-3259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBRELL",
        "first_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2023-03-07",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "MD015678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100493620",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1510208",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "338633A",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.