Russell B Kimball, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA590 Issued in ME

Practice address

250 Arsenal St
Augusta, ME 04333-0011

Phone

(207) 624-4657

Fax

(207) 287-6123

NPI assigned

Oct 13, 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

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ventura Medical Services LLCGroup PAC ID 7618342254, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Physician Assistant

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 and National Provider Directory roles.

• Ventura Medical Services LLC

  dba BThere Healthcare LLC

  • Family Medicine Physician
  • Topsham, ME
  • NPI 1639883911
  Medicare reassignment Care Compare group
• Community Health and Counseling Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bangor, ME
  • NPI 1457415184
  Medicare reassignment NPD
• Community Health and Counseling Services

  • Community Based Hospice Care Agency
  • Bangor, ME
  • NPI 1508921842
  NPD
• Spurwink Services Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, ME
  • NPI 1760507297
  NPD (past)
• State of Maine

  dba Riverview Psychiatric Hospital

  • Psychiatric Hospital
  • Augusta, ME
  • NPI 1053319566
  NPD (past)
• Tri-County Mental Health Services

  • Mental Health Counselor
  • Lewiston, ME
  • NPI 1215979158
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841380235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 JOHNSON STREET",
            "city": "SOUTH GARDINER",
            "state": "ME",
            "postal_code": "04359",
            "telephone_number": "207-512-2318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 ARSENAL ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043330011",
            "telephone_number": "207-624-4657",
            "fax_number": "207-287-6123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "RUSSELL",
        "middle_name": "B",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evelyn Kieltyka, NP
• Bruce C Kilgour, D.M.D.
• Patrick Killoran, MD
• Ashlee Mae Kimball
• Brittany Jean Kimball
• Anna Kiminski
• Reid Kincaid, PA-C
• Cheryl Ann King, LCSW
• Mark King
• Maximilian Han King, MSW

• Physician Assistant in Augusta, ME
• Providers in Augusta, ME by specialty
• Physician Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.