Individual provider Active NPI

Kimberly K McGowan, M.D.

  • Obstetrics & Gynecology Physician
  • Murfreesboro, TN
National Provider Identifier
1831148683
Registry record updated Jul 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
30765 Issued in TN
Practice address
1800 Medical Center Pkwy
Suite 350
Murfreesboro, TN 37129-2567
Phone
(615) 907-2040
Fax
(615) 907-2827
NPI assigned
May 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 30765 TN Primary

Addresses

Primary practice location

1800 Medical Center Pkwy
Suite 350
Murfreesboro, TN 37129-2567

Mailing address

1800 Medical Center Pkwy
Suite 350
Murfreesboro, TN 37129-2567
Phone (615) 907-2040

Other identifiers 1

IdentifierTypeStateIssuer
3829895MedicaidTN

Other names 1

  • Kimberly Carrelli Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100628000209 TN Practitioner - Obstetrics/Gynecology 9436234283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Medical College of Ohio, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Women'S Health Specialists, PLLCGroup PAC ID 2062488224, 5 clinicians

Practice addresses (Care Compare)

1800 Medical Ctr Pkwy
Suite 350
Murfreesboro, TN 37129-2586
Phone (615) 907-2040

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30765TNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Women'S Health Specialists, PLLC Obstetrics & Gynecology CurrentSince Mar 1, 2001 Accepting new patients
Saint Thomas Rutherford Hospital Past Accepting new patients

Locations

1800 Medical Center Pkwy
Ste 350
Murfreesboro, TN 37129
Phone (615) 907-2040

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500249600000",
    "number": "1831148683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 MEDICAL CENTER PKWY",
            "address_2": "SUITE 350",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371292567",
            "telephone_number": "615-907-2040",
            "fax_number": "615-907-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MEDICAL CENTER PKWY",
            "address_2": "SUITE 350",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371292567",
            "telephone_number": "615-907-2040",
            "fax_number": "615-907-2827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOWAN",
        "first_name": "KIMBERLY",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2017-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "30765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3829895",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "CARRELLI",
            "credential": "M.D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Murfreesboro, TN

Sources for this page

Verify at the official NPI Registry.