Active NPI
Kimberly B Mowbray, PA-C
- Physician Assistant
- Gilbert, AZ
National Provider Identifier
1588731152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 3560
- Practice address
- 1965 S Cole Dr
Gilbert, AZ 85295-4662 - Phone
- (267) 978-4461
- NPI assigned
- Nov 29, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 3560 | AZ | Primary |
Addresses
Primary practice location
1965 S Cole Dr
Gilbert, AZ 85295-4662
Mailing address
1965 S Cole Dr
Gilbert, AZ 85295-4662
Phone (267) 978-4461
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 164959 | Medicaid | AZ |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3560 | AZ | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Cardiac Specialists, Chartered | 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.
-
- Ambulatory Surgical Clinic/Center
- Mesa, AZ
- NPI 1912174590
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437091200000",
"number": "1588731152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1965 S COLE DR",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852954662",
"telephone_number": "267-978-4461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1965 S COLE DR",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852954662",
"telephone_number": "267-978-4461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOWBRAY",
"first_name": "KIMBERLY",
"middle_name": "B",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-29",
"last_updated": "2015-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "3560",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "164959",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.