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Individual provider Active NPI

Kimberly Adams Bouvette, MD

  • Physical Medicine & Rehabilitation Physician
  • Oklahoma City, OK
National Provider Identifier
1790717692
Registry record updated Dec 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
20425 Issued in OK
Practice address
4120 W Memorial Rd Ste 118
Oklahoma City, OK 73120-9322
Phone
(405) 748-4700
Fax
(405) 748-5638
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X 20425 OK
Physical Medicine & Rehabilitation Physician 208100000X 20425 OK Primary

Addresses

Primary practice location

4120 W Memorial Rd Ste 118
Oklahoma City, OK 73120-9322

Mailing address

4120 W Memorial Rd Ste 118
Oklahoma City, OK 73120-9322
Phone (405) 748-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20040714000849 OK Practitioner - Physical Medicine and Rehabilitation 8729066998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Louisville School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neuroscience Specialists PCGroup PAC ID 3375456718, 17 clinicians

Practice addresses (Care Compare)

14100 Pkwy Commons Dr
Suite 100
Oklahoma City, OK 73134-6036
Phone (405) 748-3300

Hospital & facility affiliations

  • Mercy Home Health Home health agency, Oklahoma City, OK, CCN 377048
  • Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013
  • Oklahoma Heart Hospital, LLC Hospital, Oklahoma City, OK, CCN 370215
  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093
  • Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028
  • Integris Health Edmond Hospital Hospital, Edmond, OK, CCN 370236
  • Mercy Rehabilitation Hospital Oklahoma City Inpatient rehabilitation facility, Oklahoma City, OK, CCN 373033

Merit-based Incentive Payment System (MIPS)

Final score
56.58 of 100Reported as individual
Quality
56.69
Improvement activities
0
Cost
68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20425OKMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neuroscience Specialists PC CurrentSince Jul 1, 2004 Accepting new patients
Summit Medical Center Past Accepting new patients
Mercy Rehabilitation Hospital LLC Past Accepting new patients

Locations

4120 W Memorial Rd
Ste 300
Oklahoma City, OK 73120
Phone (405) 748-3300

4120 W Memorial Rd
Ste 118
Oklahoma City, OK 73120
Phone (405) 748-4700

14100 Parkway Commons Dr
Ste 100
Oklahoma City, OK 73134
Phone (405) 242-4720

Organizations & group practices 3

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.

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387324800000",
    "number": "1790717692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 W MEMORIAL RD STE 118",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731209322",
            "telephone_number": "405-748-4700",
            "fax_number": "405-748-5638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 W MEMORIAL RD STE 118",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731209322",
            "telephone_number": "405-748-4700",
            "fax_number": "405-748-5638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUVETTE",
        "first_name": "KIMBERLY",
        "middle_name": "ADAMS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2013-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "OK",
            "license": "20425",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OK",
            "license": "20425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.