Kimberly Nicole Bagwell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C08282 Issued in MD

Practice address

500 Upper Chesapeake Dr
Bel Air, MD 21014-4324

Phone

(443) 643-1500

NPI assigned

Oct 7, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nephrology Center of Maryland, PAGroup PAC ID 1153395306, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Umd Upper Chesapeake Medical Center Hospital, Bel Air, MD, CCN 210049

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kimberly.bagwell.1@7494.direct.athenahealth.com
• FHIR API: https://fhir-myrecord.cerner.com/r4/fca878a1-6c97-4ecb-b6e7-eb5d7cde15ab/

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.

• Nephrology Center of Maryland, PA

  • Nephrology Physician
  • Baltimore, MD
  • NPI 1518932862
  Medicare reassignment Care Compare group
• Upper Chesapeake Medical Services, Inc

  • Hospitalist Physician
  • Bel Air, MD
  • NPI 1497801419
  Medicare reassignment
• Fair Oaks Hospitalist Physicians, PLLC

  • Hospitalist Physician
  • Fairfax, VA
  • NPI 1275601205

  DC

  Medicare reassignment
• HH Health System - the Orthopaedic Center, LLC

  • Orthopaedic Surgery Physician
  • Huntsville, AL
  • NPI 1376220822
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Upper Chesapeake Medical Center, Inc.

  • General Acute Care Hospital
  • Bel Air, MD
  • NPI 1598761355
  Care Compare affiliation

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1568613644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 UPPER CHESAPEAKE DR",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144324",
            "telephone_number": "443-643-1500",
            "fax_number": "443-643-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UPPER CHESAPEAKE DR",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144324",
            "telephone_number": "443-643-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "927 Franklin St SE",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "AL",
            "postal_code": "358014306",
            "country_code": "US",
            "telephone_number": "256-539-2728",
            "fax_number": "256-539-2728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAGWELL",
        "first_name": "KIMBERLY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-07",
        "last_updated": "2022-03-14",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "1081357",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AL",
            "license": "PA944",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C08282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• B-Sharp, Inc
• Christine Babcock, LMSW
• Anah Bach
• Victoria Baeten, NP
• Richard A Bafford, MD, MSPH
• Manisha Bahl, MD
• Megan Baier
• Kathryn Claire Bailey, CCC SLP
• Kristina Bailey, PHYSICIAN ASSISTANT
• Alyssa Marie Baker, LMSW

• Physician Assistant in Bel Air, MD
• Providers in Bel Air, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.