Cody J. Kimberling, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

673 Issued in NE

Practice address

601 West Leota Street
North Platte, NE 69101-6598

Phone

(308) 696-8000

NPI assigned

Oct 2, 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 1

Medicare fee-for-service enrollment

Enrolled in NE

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

Medicare enrollment (NPD)

Enrolled

Credentials

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.

• North Platte Nebraska Hospital Corporation

  • General Acute Care Hospital
  • North Platte, NE
  • NPI 1700855533
  Medicare reassignment
• North Platte Nebraska Hospital Corporation

  • Medical Oncology Physician
  • North Platte, NE
  • NPI 1134355332
  NPD
• Family Medical Center, P.C.

  • Family Medicine Physician
  • Ogallala, NE
  • NPI 1811021348
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214524800000",
    "number": "1871686519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 WEST LEOTA STREET",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691016598",
            "telephone_number": "308-696-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 WEST LEOTA STREET",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691016598",
            "telephone_number": "308-696-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBERLING",
        "first_name": "CODY",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47066229001",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Christopher Kenny, RP
• Leaann Kenworthy
• Vanessa Louise Kepler, CNA/MA
• Ashley Kerby
• Cristal Dawn Kersey
• Lloyd Lee Kimzey Jr., PHD
• Jacob King
• Kelli A L King, APRN
• Terry Lyle Kingston
• Leanne Hazel Kleckner

• Physician Assistant in North Platte, NE
• Providers in North Platte, NE by specialty
• Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.