Individual provider Active NPI

Rachael Martinez Kimball, FNP, AGACNP

  • Acute Care Nurse Practitioner
  • Gadsden, AL
National Provider Identifier
1588201685
Registry record updated Dec 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
2019034511 Issued in AL
Practice address
1007 Goodyear Ave
Gadsden, AL 35903-1100
Phone
(256) 494-4000
NPI assigned
Dec 8, 2019
Last updated
Dec 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 2019034511 AL Primary
Family Nurse Practitioner 363LF0000X 2019034508 AL

Addresses

Primary practice location

1007 Goodyear Ave
Gadsden, AL 35903-1100

Mailing address

510 Highland Ave NW
Attalla, AL 35954-1601
Phone (256) 305-9567

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20200217001583 AL Practitioner - Nurse Practitioner 6507293321 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Small Hospital Innovations LLCGroup PAC ID 0840415444, 95 clinicians

Practice addresses (Care Compare)

600 S 3Rd St
Gadsden, AL 35901-5304
Phone (256) 543-5200

Merit-based Incentive Payment System (MIPS)

Final score
95.61 of 100Reported as group
Quality
83.5
Improvement activities
40
Cost
77.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019034511ALMDAcute Care Nurse Practitioner
2019034508ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alabama Emergency Physician Partners, LLC CurrentSince Apr 18, 2020 Accepting new patients
Alabama Emergency Physician Partners, LLC CurrentSince Apr 18, 2020 Accepting new patients
App of Alabama Ed PLLC CurrentSince Jan 15, 2020 Accepting new patients
Gadsden HB Medical Services LLC CurrentSince Aug 29, 2023 Accepting new patients
Alabama Emergency Physician Partners, LLC Current Accepting new patients

Locations

4370 W Main St
Dothan, AL 36305
Phone (256) 332-1611

1007 Goodyear Ave
Gadsden, AL 35903
Phone (256) 494-4000

600 S 3rd St
Gadsden, AL 35901
Phone (256) 543-5200

5121 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 436-6556

Organizations & group practices 6

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": "1575763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575763200000",
    "number": "1588201685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 HIGHLAND AVE NW",
            "city": "ATTALLA",
            "state": "AL",
            "postal_code": "359541601",
            "telephone_number": "256-305-9567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 GOODYEAR AVE",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359031100",
            "telephone_number": "256-494-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "RACHAEL",
        "middle_name": "MARTINEZ",
        "credential": "FNP, AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-08",
        "last_updated": "2019-12-08",
        "certification_date": "2019-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "2019034511",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "2019034508",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gadsden, AL

Sources for this page

Verify at the official NPI Registry.