Individual provider Active NPI

Kimbra D Thomas, CRNP

  • Family Nurse Practitioner
  • Lancaster, PA
National Provider Identifier
1790189884
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP014190 Issued in PA
Practice address
3045 Marietta Ave
Lancaster, PA 17601-1321
Phone
(717) 207-8017
Fax
(717) 690-8826
NPI assigned
Oct 17, 2014
Last updated
Aug 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP014190 PA
Family Nurse Practitioner 363LF0000X SP014190 PA Primary

Addresses

Primary practice location

3045 Marietta Ave
Lancaster, PA 17601-1321

Mailing address

3045 Marietta Ave
Lancaster, PA 17601-1321
Phone (717) 207-8017

Other practice location 1

418 Cloverleaf Rd
Elizabethtown, PA 17022-9320
Phone (717) 653-1467

Other practice location 2

1160 Manheim Pike
Lancaster, PA 17601-3127
Phone (717) 869-4689

Other practice location 3

1871 Santa Barbara Dr Ste 1
Lancaster, PA 17601-4144
Phone (717) 560-1970

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kthomas204414@phsdirect.pinnaclehealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141120002180 PA Practitioner - Nurse Practitioner 5193947430 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lancaster General Medical GroupGroup PAC ID 0941103683, 590 clinicians

Practice addresses (Care Compare)

1001 Cornerstone Dr
Suite B
Mount Joy, PA 17552-9416
Phone (717) 653-2929

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Regional Physicians Nurse Practitioner CurrentSince Aug 29, 2022 Accepting new patients
Pinnacle Health Medical Services CurrentSince Aug 20, 2021 Accepting new patients
Pinnacle Health Medical Services CurrentSince Aug 20, 2021 Accepting new patients
Lancaster General Medical Group CurrentSince Sep 26, 2016 Accepting new patients
Pinnacle Health Regional Physicians Nurse Practitioner CurrentSince Aug 29, 2022 Accepting new patients
Lancaster General Medical Group CurrentSince Sep 26, 2016 Accepting new patients
Pinnacle Health Medical Services Current Accepting new patients
Lancaster General Medical Group Current Accepting new patients
Lancaster General Medical Group Past Accepting new patients

Locations

210 Forge Rd
Boiling Springs, PA 17007
Phone (717) 249-8300

418 Cloverleaf Rd
Elizabethtown, PA 17022
Phone (717) 653-1467

99 Masonic Dr
Ste 101
Elizabethtown, PA 17022
Phone (717) 689-4243

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

1160 Manheim Pike
Lancaster, PA 17601
Phone (717) 397-7505

1871 Santa Barbara Dr
Ste 1
Lancaster, PA 17601
Phone (717) 560-1970

2118 Spring Valley Rd
Lancaster, PA 17601
Phone (215) 615-2222

3045 Marietta Ave
Lancaster, PA 17601
Phone (717) 299-4644

1001 Cornerstone Dr
#B
Mount Joy, PA 17552
Phone (717) 653-2929

620 Spear St
Oxford, PA 19363
Phone (610) 932-9300

Organizations & group practices 9

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 3

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": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1790189884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3045 MARIETTA AVE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176011321",
            "telephone_number": "717-207-8017",
            "fax_number": "717-690-8826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3045 MARIETTA AVE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176011321",
            "telephone_number": "717-207-8017",
            "fax_number": "717-690-8826"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "418 Cloverleaf Rd",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "PA",
            "postal_code": "170229320",
            "country_code": "US",
            "telephone_number": "717-653-1467",
            "fax_number": "717-653-1001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1160 Manheim Pike",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176013127",
            "country_code": "US",
            "telephone_number": "717-869-4689",
            "fax_number": "717-869-4690",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1871 Santa Barbara Dr Ste 1",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176014144",
            "country_code": "US",
            "telephone_number": "717-560-1970",
            "fax_number": "717-560-2278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KIMBRA",
        "middle_name": "D",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-17",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP014190",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP014190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kthomas204414@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "3045 Marietta Ave",
            "city": "Lancaster",
            "state": "PA",
            "country_code": "US",
            "postal_code": "176011321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.