Individual provider Active NPI

Kimberly M Yarborough, MD

  • Emergency Medicine Physician
  • Roxboro, NC
National Provider Identifier
1912960311
Registry record updated Mar 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
9401100 Issued in NC
Practice address
615 Ridge Rd
Roxboro, NC 27573-4629
Phone
(843) 237-3378
Fax
(843) 237-5073
NPI assigned
Apr 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 9401100 NC Primary

Addresses

Primary practice location

615 Ridge Rd
Roxboro, NC 27573-4629

Mailing address

PO Box 30727
Charlotte, NC 28230-0727
Phone (843) 237-3378

Other identifiers 4

IdentifierTypeStateIssuer
89684OtherNCBCBS
Q0110BMedicaidSC
930087790OtherNCRAILROAD
8989684MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20090211000583 NC Practitioner - Emergency Medicine 2860470317 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9401100NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Person Urgent Care LLC Emergency Medicine CurrentSince Nov 1, 2017 Accepting new patients
DLP Person Urgent Care LLC CurrentSince Nov 1, 2017 Accepting new patients
Neuse River Emergency Physicians Emergency Medicine Past Accepting new patients
Person Emergency Physicans PA Emergency Medicine PastSince Jul 10, 2004 Accepting new patients
Roxboro Medaccess Primary Care Past Accepting new patients

Locations

3762 Durham Rd
Ste A
Roxboro, NC 27573
Phone (336) 330-0400

3762 Durham Rd
Roxboro, NC 27573
Phone (336) 330-0400

Organizations & group practices 5

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": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237248000000",
    "number": "1912960311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30727",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282300727",
            "telephone_number": "843-237-3378",
            "fax_number": "843-237-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 RIDGE RD",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275734629",
            "telephone_number": "843-237-3378",
            "fax_number": "843-237-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YARBOROUGH",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-08",
        "last_updated": "2009-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "9401100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "89684",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q0110B",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "930087790",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8989684",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxboro, NC

Sources for this page

Verify at the official NPI Registry.