Justin Kimbel

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

2025 Washington St
Waukegan, IL 60085-5131

Phone

(847) 360-1020

NPI assigned

Oct 19, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: justin.kimbel.p1@direct.lakecountyil.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.

• County of Lake

  • Public Health or Welfare Agency
  • Waukegan, IL
  • NPI 1013920750
  NPD
• County of Lake

  • Federally Qualified Health Center (FQHC)
  • Round Lake, IL
  • NPI 1639588254
  NPD

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640390400000",
    "number": "1780283184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 WASHINGTON ST",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600855131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 WASHINGTON ST",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600855131",
            "telephone_number": "847-360-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBEL",
        "first_name": "JUSTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-19",
        "last_updated": "2021-12-25",
        "certification_date": "2021-12-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yusra Khan
• Julianne Khanina, PMHNP
• Kids Above All Illinois
• Robert Kieffer, D.C.
• Kiley Center
• Catrina Marie Kimble
• Brittany King
• Teresa Kaye King
• Kingston Healthcare Consulting, LLC
• Kingston Healthcare Consulting, LLC

• Professional Counselor in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 2021; 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.