Individual provider Active NPI

Michelle K. Kimball, ANP-BC

  • Adult Health Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1598964009
Registry record updated Mar 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP107871 Issued in TX
Practice address
1300 W Terrell #500
Ft. Worth, TX 76104-2810
Phone
(817) 252-5000
Fax
(817) 252-5060
NPI assigned
Jul 13, 2007
Last updated
Mar 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP107871 TX Primary

Addresses

Primary practice location

1300 W Terrell #500
Ft. Worth, TX 76104-2810

Mailing address

1300 W. Terrell #500
Consultants in Cardiology, PA
Ft. Worth, TX 76104-2810
Phone (817) 252-5000

Other names 1

  • Ms. Michelle K. Jones-Kimball Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20090115000385 TX Practitioner - Nurse Practitioner 3779646831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

1300 W Terrell Ave
Suite 500
Fort Worth, TX 76104-2821
Phone (817) 252-5000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince Sep 1, 2016 Accepting new patients
Texas Health Physicians Group CurrentSince Sep 1, 2016 Accepting new patients
Texas Health Physicians Group Current Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

1300 W Terrell Ave
Ste 500
Ft Worth, TX 76104
Phone (817) 252-5000

6100 Harris Pkwy
Ft Worth, TX 76132
Phone (817) 346-5000

Interoperability endpoints

  • Direct secure messaging: mkimball3081@direct.texashealth.org

Organizations & group practices 3

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": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1598964009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W. TERRELL #500",
            "address_2": "CONSULTANTS IN CARDIOLOGY, PA",
            "city": "FT. WORTH",
            "state": "TX",
            "postal_code": "761042810",
            "telephone_number": "817-252-5000",
            "fax_number": "817-252-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W TERRELL #500",
            "city": "FT. WORTH",
            "state": "TX",
            "postal_code": "761042810",
            "telephone_number": "817-252-5000",
            "fax_number": "817-252-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "MICHELLE",
        "middle_name": "K.",
        "name_prefix": "Ms.",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-13",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP107871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "JONES-KIMBALL",
            "middle_name": "K.",
            "prefix": "MS.",
            "credential": "ANP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.