Individual provider Active NPI

William Bradley Kimbrough III, M.D.

  • Surgery Physician
  • Gonzales, LA
National Provider Identifier
1871772202
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD202378 Issued in LA
Practice address
1014 Saint Clair Blvd
Suite 3015
Gonzales, LA 70737-5023
Phone
(225) 743-2455
Fax
(225) 644-5213
NPI assigned
Nov 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD202378 LA Primary

Addresses

Primary practice location

1014 Saint Clair Blvd
Suite 3015
Gonzales, LA 70737-5023

Mailing address

8962 Cottage Dr
Baton Rouge, LA 70806-8605
Phone (225) 276-4947

Other identifiers 1

IdentifierTypeStateIssuer
1508543MedicaidLA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address wkimbrough8901@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20110908001898 LA Practitioner - General Surgery 1951571561 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD202378LAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Woman's Surgical Specialty Group Surgery CurrentSince Apr 1, 2021 Accepting new patients

Locations

500 Rue de la Vie St
Ste 402
Baton Rouge, LA 70817
Phone (225) 215-7588

Interoperability endpoints

  • Direct secure messaging: wkimbrough8901@direct.casso.us.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1871772202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8962 COTTAGE DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708068605",
            "telephone_number": "225-276-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 SAINT CLAIR BLVD",
            "address_2": "SUITE 3015",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707375023",
            "telephone_number": "225-743-2455",
            "fax_number": "225-644-5213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBROUGH",
        "first_name": "WILLIAM",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-01",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "MD202378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508543",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wkimbrough8901@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "wkimbrough8901@direct.casso.us.com",
            "address_1": "1014 Saint Clair Blvd",
            "address_2": "Suite 3015",
            "city": "Gonzales",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707375023",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1014 Saint Clair Blvd",
            "address_2": "Suite 3015",
            "city": "Gonzales",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707375023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gonzales, LA

Sources for this page

Verify at the official NPI Registry.