Kimberley Anna Brown, PA C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1043 Issued in NE

Practice address

5500 Pine Lake Rd
Lincoln, NE 68516-3389

Phone

(402) 489-8888

Fax

(402) 421-1945

NPI assigned

Jul 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Kimberley Anna Wragge Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1558384826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 PINE LAKE RD",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685163389",
            "telephone_number": "402-489-8888",
            "fax_number": "402-421-1945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 PINE LAKE RD",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685163389",
            "telephone_number": "402-489-8888",
            "fax_number": "402-421-1945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KIMBERLEY",
        "middle_name": "ANNA",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "37314",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "238809",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "1900420",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "970028870",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLEY",
            "last_name": "WRAGGE",
            "middle_name": "ANNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Justice Brown
• Justice Brown
• Katrina Brown
• Keith Brown
• Kevann Ann Brown
• Kirk L Brown, L.M.H.P.
• Kristin Brown
• Lindsey Nichole Brown, PLMHP
• Mackenzie Jane Brown, PT
• Margo Lynn Brown

• Physician Assistant in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; 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.