Derrick E Kimble Inc

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC005188 Issued in GA

Legal business name

DERRICK E KIMBLE INC

Practice address

2903 Galahad Way
Augusta, GA 30909-9147

Phone

(706) 495-2351

NPI assigned

Dec 13, 2011

Organization subpart

No

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

Authorized official

Name

Derrick E Kimble, MED

Title

Ceo

Phone

(706) 495-2351

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1323734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323734400000",
    "number": "1902174345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2903 GALAHAD WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309099147",
            "telephone_number": "706-495-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2903 GALAHAD WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309099147",
            "telephone_number": "706-495-2351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERRICK E KIMBLE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-13",
        "last_updated": "2011-12-13",
        "status": "A",
        "authorized_official_last_name": "KIMBLE",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-495-2351",
        "authorized_official_credential": "MED"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC005188",
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "GA",
            "license": "RN107823",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Elaine Deremer, PHARM.D., BCPS
• Ashton Deremigio, DPT
• Paul-Robert Derenoncourt, MD
• Dermatology and Skin Cancer Center of Augusta, P.C.
• Scott S Derossi, DMD
• Derrick E. Kimble Inc
• Jay Desai, M.D.
• Julinkumar J Desai, M.D,
• Ketki Desai, MD
• Koosh Desai, MD

• Professional Counselor in Augusta, GA
• Providers in Augusta, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.