Active NPI
Kirk Kendall Kimmons, LMBT
- Massage Therapist
- New Bern, NC
National Provider Identifier
1699123919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- NC 13551
- Practice address
- 1505 S Glenburnie Rd
Suite K
New Bern, NC 28562-2625 - Phone
- (252) 646-7181
- NPI assigned
- May 26, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | NC 13551 | NC | Primary |
Addresses
Primary practice location
1505 S Glenburnie Rd
Suite K
New Bern, NC 28562-2625
Mailing address
101 E Lariat LN
Havelock, NC 28532-2940
Phone (252) 646-7181
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NC 13551 | NC | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464220800000",
"number": "1699123919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 E LARIAT LN",
"city": "HAVELOCK",
"state": "NC",
"postal_code": "285322940",
"telephone_number": "252-646-7181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 S GLENBURNIE RD",
"address_2": "SUITE K",
"city": "NEW BERN",
"state": "NC",
"postal_code": "285622625",
"telephone_number": "252-646-7181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMMONS",
"first_name": "KIRK",
"middle_name": "KENDALL",
"credential": "LMBT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-05-26",
"last_updated": "2016-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NC",
"license": "NC 13551",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Bern, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.