Kimberly Beth Macintire, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2091 Issued in TN

Practice address

400 Goodys LN
Knoxville, TN 37922-1900

Phone

(865) 288-8327

Fax

(865) 288-5903

NPI assigned

Oct 20, 2011

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 TN

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: kimberly.macintire.p1@direct.orthotn.nextgenshare.com

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.

• Leconte Orthopedics, PLLC

  • Orthopaedic Surgery Physician
  • Sevierville, TN
  • NPI 1235552381
  Medicare reassignment
• Orthotennessee

  • Multi-Specialty Clinic/Center
  • Knoxville, TN
  • NPI 1841508751
  NPD (past)
• River Valley Emergency Physicians, Inc

  • Emergency Medicine Physician
  • Huntington, WV
  • NPI 1649384660

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1609151786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 FORT SANDERS WEST BLVD",
            "address_2": "STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223355",
            "telephone_number": "865-231-9481",
            "fax_number": "865-769-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 GOODYS LN",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379221900",
            "telephone_number": "865-288-8327",
            "fax_number": "865-288-5903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACINTIRE",
        "first_name": "KIMBERLY",
        "middle_name": "BETH",
        "name_prefix": "Miss",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-20",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA.892",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "2091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Elizabeth Macguire Bolling, DPT
• Cole Mach
• Charles William Machen, M.D.
• Jessica Machluf
• Katya Macias Curiel
• John Walter Mack Jr., MD
• Suzanne Mack
• Alison Laurette Mackay, MS
• Katherine Mackay, LMSW
• Sheryl Mackenzie-Amburn

• Physician Assistant in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.