Individual provider Active NPI

Nicholas Allen Kimpel, D.O.

  • Emergency Medicine Physician
  • New Market, AL
National Provider Identifier
1912104266
Registry record updated Sep 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
#DO1133 Issued in AL
Practice address
460 Saint Clair Drive
New Market, AL 35761
Phone
(803) 522-0953
NPI assigned
Jun 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X RTP002340 GA
Emergency Medicine Physician 207P00000X #DO1133 AL Primary
Emergency Medicine Physician 207P00000X 062130 GA

Addresses

Primary practice location

460 Saint Clair Drive
New Market, AL 35761

Mailing address

460 Saint Clair Drive
New Market, AL 35761
Phone (803) 522-0953

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100921000600 AL Practitioner - Emergency Medicine 3274687660 Reassigns benefits to 1 organization
I20191209001189 GA Practitioner - Emergency Medicine 3274687660

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
#DO1133ALMDEmergency Medicine Physician
RTP002340GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ogeechee Valley Emergency Physicians Emergency Medicine Past Accepting new patients
Washington Wilkes Emergency Physicians LLC Emergency Medicine Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283385600000",
    "number": "1912104266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 SAINT CLAIR DRIVE",
            "city": "NEW MARKET",
            "state": "AL",
            "postal_code": "35761",
            "telephone_number": "803-522-0953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 SAINT CLAIR DRIVE",
            "city": "NEW MARKET",
            "state": "AL",
            "postal_code": "35761",
            "telephone_number": "803-522-0953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMPEL",
        "first_name": "NICHOLAS",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2010-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "RTP002340",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "#DO1133",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "062130",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Market, AL

Sources for this page

Verify at the official NPI Registry.