Traci A. Kimball, MD CWSP

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

DR49586 Issued in CO

Practice address

10050 Ralston Rd Unit 3
Arvada, CO 80004-4974

Phone

(303) 940-1611

Fax

(303) 432-2296

NPI assigned

Jan 30, 2007

Last updated

Apr 5, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 13

Addresses

Other identifiers 1

Other names 1

• Traci M. Angelica Former name

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

General SurgeryAlso: Undersea and Hyperbaric Medicine, Vascular Surgery

Education

University of Texas Medical School at San Antonio, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Traci a. Kimball MD PC

  dba The WISH Clinic

  • Multi-Specialty Clinic/Center
  • Arvada, CO
  • NPI 1326449646

  Health & Wellness Coach

  Medicare reassignment NPD Authorized official
• Traci a. Kimball MD PC

  dba The Wish Clinic

  • Durable Medical Equipment & Medical Supplies
  • Arvada, CO
  • NPI 1174305601

  Health & Wellness Coach

  NPD Authorized official
• Homedoc, PC

  dba Colorado HomeDoc

  • Internal Medicine Physician
  • Erie, CO
  • NPI 1821818832
  Medicare reassignment

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743811200000",
    "number": "1841337110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10050 RALSTON RD UNIT 3",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800044974",
            "telephone_number": "303-940-1611",
            "fax_number": "303-432-2296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10050 RALSTON RD UNIT 3",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800044974",
            "telephone_number": "303-940-1611",
            "fax_number": "303-432-2296"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4798 S Acoma St",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "CO",
            "postal_code": "801106541",
            "country_code": "US",
            "telephone_number": "303-940-1611",
            "fax_number": "303-423-2296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "TRACI",
        "middle_name": "A.",
        "credential": "MD CWSP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2025-04-05",
        "certification_date": "2025-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1744R1102X",
            "taxonomy_group": "",
            "desc": "Specialist, Research Study",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175L00000X",
            "taxonomy_group": "",
            "desc": "Homeopath",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CO",
            "license": "DR49586",
            "primary": false
        },
        {
            "code": "246XC2903X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist Cardiovascular, Vascular Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246ZB0301X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Biomedical Engineering",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CO",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "DR49586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "98159241",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACI",
            "last_name": "ANGELICA",
            "middle_name": "M.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kids 'N Touch, LLC
• Matthew Kiebish
• Craig Kilpatrick, MD
• Elisa Kim Lee, DDS
• Crystal Kim, DMD
• Adam Gregory Kimber, LAC
• Michael Everett Kimmey, EMT
• Kindhearts LLC (Kind Hearts Kids Gym Arvada)
• Michelle King-Chrisman, PA-C
• Daniel King

• Surgery Physician in Arvada, CO
• Providers in Arvada, CO by specialty
• Surgery Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2025; 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.