Charles William Kimbrough, MD

Primary specialty

Surgical Oncology PhysicianTaxonomy code 2086X0206X

License

S3217 Issued in TX

Practice address

3410 Worth St Ste 235
Dallas, TX 75246-2071

Phone

(214) 820-2302

NPI assigned

Mar 30, 2010

Last updated

Nov 8, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

University of Texas Medical Branch at Galveston, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Scott & White Medical Center- Waxahachie Hospital, Waxahachie, TX, CCN 450372
• Baylor University Medical Center Hospital, Dallas, TX, CCN 450021

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ckimbrough559744@direct.sw.org

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.

• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936

  Surgery

  Medicare reassignment Care Compare group NPD
• Healthtexas Provider Network

  dba Symmetry Anesthesia

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Colleyville, TX
  • NPI 1235135906

  Surgery

  NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Plano, TX
  • NPI 1003811639
  NPD (past)

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

• Baylor Medical Center at Waxahachie

  dba Baylor Scott & White Medical Center - Waxahachie

  • General Acute Care Hospital
  • Waxahachie, TX
  • NPI 1265430177
  Care Compare affiliation
• Baylor University Medical Center

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1447250253
  Care Compare affiliation

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1639494834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 WORTH ST STE 235",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462071",
            "telephone_number": "214-820-2302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 WORTH ST STE 235",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462071",
            "telephone_number": "214-820-2302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBROUGH",
        "first_name": "CHARLES",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-30",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "S3217",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "TX",
            "license": "S3217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ckimbrough559744@direct.sw.org",
            "affiliation": "N",
            "address_1": "3410 Worth St Ste 235",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752462071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kimberly Mezera MD PLLC
• Nkiruka Helen Kimble, APRN, PMHNP-BC
• Hillary Kimbley, PH.D.
• Michael Thomas Kimbrell, MD
• Misty Dale Kimbrell, DNP, RN, ACNP-BC
• Marquisha Kimbrough, B.S.
• Samantha Newton Kimbrough, MSN, APRN, A-GNP-C
• Nyamizi Ruth Kimisha, LVN
• Kimodale Inc (Hunts Pharmacy)
• Kimodale, Inc. (Hunt Drug & Pharmacy (Hunts Pharmacy))

• Surgical Oncology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Surgical Oncology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.