Kimberly A Harbin, M.D.
Individual provider Active NPI Family Medicine Physician · Cairo, GA
NPI 1790731867 · NPPES record last updated Nov 4, 2020
Key facts
- NPI
- 1790731867
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 050087 (GU)
- Practice address
- 235 1St Ave NE
Cairo, GA 39828-2118 - Phone
- (229) 378-2214
- Fax
- (229) 246-9322
- NPI assigned
- May 26, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 11
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Medical College of Georgia School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Hospital Authority of the City of Bainbridge and Decatur County
Southland Consolidated Emergency Services LLC
Practice addresses (Care Compare)
1500 E Shotwell St
Bainbridge, GA 39819-4256
Phone (229) 246-3500
235 1St Ave NE
Cairo, GA 39828-2118
Phone (229) 378-2214
Hospital & facility affiliations
- Archbold Home Health Services
- Centerwell Home Health
- Grady General Hospital
- Memorial Hospital and Manor
- Archbold Memorial Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of nail tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060821000303 | GA | Practitioner - Family Practice |
0941203590 | Reassigns benefits to 7 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 050087 | GU | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southland Emergency Medical Services, L.L.C | Emergency Medicine | Current |
Accepting new patients |
| South Georgia Emergency Medicine Associates PC | Emergency Medicine | Current |
Accepting new patients |
| Department of Behavioral Health & Developmental Disabilities, Ga | Current |
Accepting new patients | |
| PMS 68 LLC | Family Medicine | Current |
Accepting new patients |
| Hospital Authority of the City of Bainbridge and Decatur County Georgi | Current |
Accepting new patients | |
| Hospital Authority of the City of Bainbridge and Decatur County | Current |
Accepting new patients | |
| Department of Behavioral Health and Developmental Disabilities | Current | Accepting new patients | |
| Southland Consolidated Emergency Services, LLC | Emergency Medicine | Current |
Accepting new patients |
Locations
3405 Old Savannah Rd
Augusta, GA 30906
Phone (705) 790-2030
1500 E Shotwell St
Bainbridge, GA 39819
Phone (229) 243-6100
235 1st Ave NE
Cairo, GA 39828
Phone (229) 254-2117
1155 5th St SE
Cairo, GA 39828
Phone (229) 226-3060
90 E Stephens St
Camilla, GA 31730
Phone (229) 200-4950
4 Medical Dr
Elberton, GA 30635
Phone (706) 213-2527
400 S Pinetree Blvd
Thomasville, GA 31792
Phone (229) 227-2990
915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575
2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 050087 | GA | |
| Family Medicine Physician | 207Q00000X | 050087 | GU | Yes |
Addresses
Primary practice location
235 1St Ave NE
Cairo, GA 39828-2118
Mailing address
235 1St Ave NE
Cairo, GA 39828-2118
Phone (229) 378-2214
Other practice location 1
102 N Wiley Ave
Donalsonville, GA 39845
Phone (229) 524-5217
Other practice location 2
2501 N Patterson St
Valdosta, GA 31602-1785
Phone (229) 433-1000
Other practice location 3
90 E Stephens St
Camilla, GA 31730-1836
Phone (229) 336-4644
Other practice location 4
1155 5th St SE
Cairo, GA 39828-3162
Phone (229) 377-1150
Other practice location 5
1500 E Shotwell St
Bainbridge, GA 39819-4294
Phone (229) 243-1700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000954412A | Medicaid | GA | |
| 050087 | Other | GA | MEDICAL LICENSE |
NPI Registry JSON
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604448000000",
"number": "1790731867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 1ST AVE NE",
"city": "CAIRO",
"state": "GA",
"postal_code": "398282118",
"telephone_number": "229-378-2214",
"fax_number": "229-246-9322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 1ST AVE NE",
"city": "CAIRO",
"state": "GA",
"postal_code": "398282118",
"telephone_number": "229-378-2214",
"fax_number": "229-246-9322"
}
],
"practiceLocations": [
{
"address_1": "102 N Wiley Ave",
"address_purpose": "LOCATION",
"city": "Donalsonville",
"state": "GA",
"postal_code": "39845",
"country_code": "US",
"telephone_number": "229-524-5217",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2501 N Patterson St",
"address_purpose": "LOCATION",
"city": "Valdosta",
"state": "GA",
"postal_code": "316021785",
"country_code": "US",
"telephone_number": "229-433-1000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "90 E Stephens St",
"address_purpose": "LOCATION",
"city": "Camilla",
"state": "GA",
"postal_code": "317301836",
"country_code": "US",
"telephone_number": "229-336-4644",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1155 5th St SE",
"address_purpose": "LOCATION",
"city": "Cairo",
"state": "GA",
"postal_code": "398283162",
"country_code": "US",
"telephone_number": "229-377-1150",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1500 E Shotwell St",
"address_purpose": "LOCATION",
"city": "Bainbridge",
"state": "GA",
"postal_code": "398194294",
"country_code": "US",
"telephone_number": "229-243-1700",
"fax_number": "229-246-9322",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HARBIN",
"first_name": "KIMBERLY",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-26",
"last_updated": "2020-11-04",
"certification_date": "2020-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "GA",
"license": "050087",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GU",
"license": "050087",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000954412A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "050087",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cairo, GA
- Grady Primary Care, L.L.C.
- Anna C Gray
- Mya Pope Greenberg
- Darlene Halstead
- Mona E Hancock
- Greta Harrison
- Hannah Legette Harrison
- Lonnie R Harrison
- Keri Hartsell
- Harvest Health LLC
All providers in Cairo, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.