Individual provider Active NPI

Kelly R Kimbrell, APRN

  • Family Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1881105161
Registry record updated Sep 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
101588 Issued in OK
Practice address
4140 W Memorial Rd Ste 215
Oklahoma City, OK 73120-8361
Phone
(405) 242-4030
Fax
(405) 242-4031
NPI assigned
Oct 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 101588 OK Primary

Addresses

Primary practice location

4140 W Memorial Rd Ste 215
Oklahoma City, OK 73120-8361

Mailing address

4140 W Memorial Rd Ste 215
Oklahoma City, OK 73120-8361
Phone (405) 242-4030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20180412001459 OK Practitioner - Nurse Practitioner 6406119080 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

4140 W Memorial Rd
215 Mercy Clinic
Oklahoma City, OK 73120-8361
Phone (405) 936-5888

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
101588OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Linzi L Stewart, D.O., P.L.L.C. CurrentSince May 1, 2018 Accepting new patients
Mercy Clinic Oklahoma Communities CurrentSince Sep 10, 2018 Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients

Locations

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

4140 W Memorial Rd
Ste 215
Oklahoma City, OK 73120
Phone (405) 242-4030

10400 S Western Ave
Ste 7
Oklahoma City, OK 73139
Phone (405) 632-7256

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

Interoperability endpoints

  • Direct secure messaging: kkimbrell994236@directc.mercy.net

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1507852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1881105161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 W MEMORIAL RD STE 215",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208361",
            "telephone_number": "405-242-4030",
            "fax_number": "405-242-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 W MEMORIAL RD STE 215",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208361",
            "telephone_number": "405-242-4030",
            "fax_number": "405-242-4031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBRELL",
        "first_name": "KELLY",
        "middle_name": "R",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-13",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "101588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.