Michael K Kimbro, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD24044 Issued in TN

Practice address

1901 S Shady St
Mountain City, TN 37683-2021

Phone

(423) 727-1100

Fax

(423) 727-1105

NPI assigned

Apr 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Merit-based Incentive Payment System (MIPS)

Final score

90.33 of 100Reported as group

Quality

83.8

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkimbro2754727@carolinashealthcaresystem.direct-ci.com

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.

• Tri-Cities Regional Emergency Physicians, PC

  • Emergency Medicine Physician
  • Johnson City, TN
  • NPI 1063950046
  NPD
• Mountain States Health Alliance

  • Psychiatric Hospital Unit
  • Kingsport, TN
  • NPI 1417050980
  NPD (past)

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261094400000",
    "number": "1831155951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 S SHADY ST",
            "city": "MOUNTAIN CITY",
            "state": "TN",
            "postal_code": "376832021",
            "telephone_number": "423-727-1100",
            "fax_number": "423-727-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 S SHADY ST",
            "city": "MOUNTAIN CITY",
            "state": "TN",
            "postal_code": "376832021",
            "telephone_number": "423-727-1100",
            "fax_number": "423-727-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBRO",
        "first_name": "MICHAEL",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2009-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD24044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "TN01661",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3859222",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4062631",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen Barrett Jones, DMD
• Charles Justice
• Keystone Continuum, LLC
• Keystone Continuum, LLC
• Keystone Continuum, LLC
• Maurice Douglas Kistner, D.PH
• Kimberly Kay Kleine, MSN, ARPN, FNP-C
• Carter Knecht, DC
• Sandra Kay Lawson, DPH.
• Cristy Gillespie Lee, MD

• All providers in Mountain City, TN
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.