NPIMap

Individual provider Active NPI

Kimberly A. Addis, M.D.

  • Diagnostic Radiology Physician
  • Longview, TX
National Provider Identifier
1720064652
Registry record updated Oct 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
M1466 Issued in TX
Practice address
4777 US Highway 259
Longview, TX 75605-7668
Phone
(903) 663-7393
Fax
(903) 663-7394
NPI assigned
Dec 22, 2005
Last updated
Oct 13, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X DR.0050065 CO
Diagnostic Radiology Physician 2085R0202X M1466 TX Primary
Vascular & Interventional Radiology Physician 2085R0204X M1446 TX
General Practice Physician 208D00000X M1446 TX

Addresses

Primary practice location

4777 US Highway 259
Longview, TX 75605-7668

Mailing address

4777 US Highway 259
Longview, TX 75605-7668
Phone (903) 663-7393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050922000858 TX Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 0547294118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Pennsylvania State University College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Singleton Associates PAGroup PAC ID 6305731118, 814 clinicians

Practice addresses (Care Compare)

11100 Shadow Creek Pkwy
Pearland, TX 77584-7285
Phone (713) 461-3573

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M1466TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Singleton Associates PA Diagnostic Radiology CurrentSince Dec 1, 2018 Accepting new patients
Diagnostic MRI Central LLC Diagnostic Radiology CurrentSince Nov 7, 2020 Accepting new patients
Radcare of Texas PLLC Diagnostic Radiology Past Accepting new patients
River City Imaging Associates PA Diagnostic Radiology PastSince Dec 17, 2023 Accepting new patients
Radiology Associates of San Antonio,P.a. Diagnostic Radiology Past Accepting new patients
River City Imaging Centers LLC PastSince May 9, 2021 Accepting new patients
Four Seasons Breast Foundation Past Accepting new patients

Locations

1501 S Coulter St
Amarillo, TX 79106
Phone (800) 354-1150

100 E Alton Gloor Blvd
Brownsville, TX 78526
Phone (956) 350-7000

100 E Alton Gloor Blvd
#A
Brownsville, TX 78526
Phone (956) 350-7000

21214 Northwest Fwy
Cypress, TX 77429
Phone (832) 912-3500

9440 Poppy Dr
Dallas, TX 75218
Phone (214) 324-6100

10301 Gateway Blvd W
El Paso, TX 79925
Phone (915) 543-2424

1801 N Oregon St
El Paso, TX 79902
Phone (409) 883-9361

1110 N Sarah Dewitt Dr
Gonzales, TX 78629
Phone (830) 672-3845

6720 Bertner Ave
#2270
Houston, TX 77030
Phone (832) 355-4092

850 W Central Texas Expy
Killeen, TX 76548
Phone (254) 690-0900

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

9155 Grapevine Hwy
Ste 120
North Richland Hills, TX 76180

11100 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 770-7000

8902 Floyd Curl Dr
San Antonio, TX 78240
Phone (210) 690-7000

6801 Emmett F Lowry Expy
Texas City, TX 77591
Phone (409) 938-5095

Organizations & group practices 7

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.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444694400000",
    "number": "1720064652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4777 US HIGHWAY 259",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756057668",
            "telephone_number": "903-663-7393",
            "fax_number": "903-663-7394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4777 US HIGHWAY 259",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756057668",
            "telephone_number": "903-663-7393",
            "fax_number": "903-663-7394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDIS",
        "first_name": "KIMBERLY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2015-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "DR.0050065",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "M1466",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TX",
            "license": "M1446",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "M1446",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.