Michelle S Kimball, CPNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

7392 Issued in TN

Practice address

1101 Carter Street
Chattanooga, TN 37402

Phone

(423) 490-7710

Fax

(423) 490-7750

NPI assigned

Oct 18, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

Practice roles

Interoperability endpoints

• Direct secure messaging: michelle.kimball.1@4286.direct.athenahealth.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.

• Mose and Garrison Siskin Memorial Foundation, Inc.

  • Specialist
  • Chattanooga, TN
  • NPI 1902132509

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468368000000",
    "number": "1699764084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 CARTER STREET",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37402",
            "telephone_number": "423-490-7710",
            "fax_number": "423-490-7750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 CARTER STREET",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37402",
            "telephone_number": "423-490-7710",
            "fax_number": "423-490-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "MICHELLE",
        "middle_name": "S",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-18",
        "last_updated": "2016-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "7392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4046834",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00901128B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra L Kilpatrick, PHD
• Nia-Marie Kilstofte
• Jennifer Kim, DC
• John S Kim, MD
• James Foster Kimball, D.D.S.
• Connor William Kimbrell, MD
• Kimsey Radiation Oncology
• Kimsey-Knight Radiology, P.C.
• Frank Charles Kimsey, MD
• Lauren Nicole Kindle, PA-C

• Nurse Practitioner in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.

Verify at the official NPI Registry.