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

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 6

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

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 (22 clinicians)
Southland Consolidated Emergency Services LLC (68 clinicians)

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 Home health agency · Thomasville, GA · CCN 117024
  • Centerwell Home Health Home health agency · Bainbridge, GA · CCN 117151
  • Grady General Hospital Hospital · Cairo, GA · CCN 110121
  • Memorial Hospital and Manor Hospital · Bainbridge, GA · CCN 110132
  • Archbold Memorial Hospital Hospital · Thomasville, GA · CCN 110038

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10

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 IDStateProvider typePAC IDDetails
I20060821000303 GA Practitioner - Family Practice
Practitioner - Emergency Medicine
0941203590 Reassigns benefits to 7 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
050087GUMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southland Emergency Medical Services, L.L.C Emergency Medicine Current
since Jul 1, 2014
Accepting new patients
South Georgia Emergency Medicine Associates PC Emergency Medicine Current
since Jan 15, 2020
Accepting new patients
Department of Behavioral Health & Developmental Disabilities, Ga Current
since Oct 3, 2009
Accepting new patients
PMS 68 LLC Family Medicine Current
since Aug 1, 2020
Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Georgi Current
since Nov 1, 2014
Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Current
since Nov 1, 2014
Accepting new patients
Department of Behavioral Health and Developmental Disabilities Current Accepting new patients
Southland Consolidated Emergency Services, LLC Emergency Medicine Current
since Oct 1, 2019
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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
000954412AMedicaidGA
050087OtherGAMEDICAL LICENSE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 4, 2020.

{
    "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

All providers in Cairo, GA · Family Medicine Physician in Georgia

Sources for this page

Verify at the official NPI Registry.