Individual provider Active NPI

Robert S Kimberlain, D.C

  • Chiropractor
  • Louisville, KY
National Provider Identifier
1538284625
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
249677 Issued in KY
Practice address
100 Mallard Creek Rd Ste 205
Louisville, KY 40207-5136
Phone
(502) 259-9670
Fax
(502) 272-0973
NPI assigned
Mar 20, 2007
Last updated
Feb 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 249677 KY Primary

Addresses

Primary practice location

100 Mallard Creek Rd Ste 205
Louisville, KY 40207-5136

Mailing address

100 Mallard Creek Rd Ste 205
Louisville, KY 40207-5136
Phone (502) 259-9670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070725000381 KY Practitioner - Chiropractic 9234230947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 Mallard Creek Rd
Suite 205
Louisville, KY 40207-5136
Phone (502) 259-9670

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
249677KYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness First Chiropractic, PLLC Chiropractor CurrentSince May 7, 2007 Accepting new patients

Locations

100 Mallard Creek Rd
Ste 205
Louisville, KY 40207
Phone (502) 259-9670

4010 DuPont Cir
Ste 516
Louisville, KY 40207

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, 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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1538284625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MALLARD CREEK RD STE 205",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402075136",
            "telephone_number": "502-259-9670",
            "fax_number": "502-272-0973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MALLARD CREEK RD STE 205",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402075136",
            "telephone_number": "502-259-9670",
            "fax_number": "502-272-0973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBERLAIN",
        "first_name": "ROBERT",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "249677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.