Individual provider Active NPI

Amy Cone Kimble, NP-C

  • Family Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1851384374
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12071 Issued in TN
Practice address
262 Danny Thomas PL
Ms 800
Memphis, TN 38105-3678
Phone
(901) 495-3006
Fax
(901) 495-3842
NPI assigned
Aug 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 12071 TN
Family Nurse Practitioner 363LF0000X 12071 TN Primary
Pediatric Registered Nurse 163WP0200X 154526 TN

Addresses

Primary practice location

262 Danny Thomas PL
Ms 800
Memphis, TN 38105-3678

Mailing address

262 Danny Thomas PL
Ms 800
Memphis, TN 38105-3678
Phone (901) 495-3006

Other identifiers 1

IdentifierTypeStateIssuer
0101110220MedicaidVA

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210113001443 TN Practitioner - Nurse Practitioner 4486602711 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
154526TNMDPediatric Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
St Jude Children'S Research Hospital, Inc. Pediatrics CurrentSince Oct 1, 2020 Accepting new patients

Locations

262 Danny Thomas Pl
Memphis, TN 38105
Phone (888) 226-4343

262 Danny Thomas Pl
#800
Memphis, TN 38105
Phone (901) 595-6216

262 Danny Thomas Pl
#515
Memphis, TN 38105
Phone (901) 495-3006

Organizations & group practices 1

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1851384374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 DANNY THOMAS PL",
            "address_2": "MS 800",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381053678",
            "telephone_number": "901-495-3006",
            "fax_number": "901-495-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 DANNY THOMAS PL",
            "address_2": "MS 800",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381053678",
            "telephone_number": "901-495-3006",
            "fax_number": "901-495-3842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBLE",
        "first_name": "AMY",
        "middle_name": "CONE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "12071",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "12071",
            "primary": true
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "TN",
            "license": "154526",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0101110220",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.