Individual provider Active NPI

Kimberly Ann Howerton, MD

  • Family Medicine Physician
  • Jackson, TN
National Provider Identifier
1922002336
Registry record updated Jun 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31314 Issued in TN
Practice address
25 Security Dr
Jackson, TN 38305-3754
Phone
(731) 215-2888
Fax
(731) 215-2752
NPI assigned
Jun 13, 2005
Last updated
Jun 20, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 31314 TN Primary

Addresses

Primary practice location

25 Security Dr
Jackson, TN 38305-3754

Mailing address

25 Security Dr
Jackson, TN 38305-3754
Phone (731) 215-2888

Other identifiers 8

IdentifierTypeStateIssuer
39401OtherTNTLC
626001636OtherTNUSA MANAGED CARE
6391611OtherTNCIGNA
3850931MedicaidTN
4105358OtherTNBLUE CROSS BLUE SHIELD
626001636OtherTNHEALTH PARTNERS
626001636OtherTNUNITED HEALTHCARE
168928OtherTNUNISON

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20050801000128 TN Practitioner - Family Practice 5092743039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Tennessee, HSC, College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3019 N Highland Ave
Jackson, TN 38305-3411
Phone (731) 215-2888

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31314TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Patient Centered Physician's Care, P.C. Family Medicine CurrentSince Jun 12, 2010 Accepting new patients
University of Tennessee Family Medicine Current Accepting new patients
Physicians Quality Care PLLC Past Accepting new patients

Locations

25 Security Dr
Jackson, TN 38305
Phone (731) 215-2888

294 Summar Dr
Jackson, TN 38301
Phone (731) 423-1932

3019 N Highland Ave
Jackson, TN 38305
Phone (731) 215-2888

875 Union Ave
Rm C309
Memphis, TN 38103
Phone (901) 448-5876

Interoperability endpoints

  • Direct secure messaging: kimberly.howerton@10808041996292.direct.elationemr.com
  • Direct secure messaging: kimberly.howerton@117372888809476.direct.elationemr.com

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

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": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371686400000",
    "number": "1922002336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 SECURITY DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053754",
            "telephone_number": "731-215-2888",
            "fax_number": "731-215-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 SECURITY DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053754",
            "telephone_number": "731-215-2888",
            "fax_number": "731-215-2752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWERTON",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-13",
        "last_updated": "2013-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "31314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TLC",
            "identifier": "39401",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USA MANAGED CARE",
            "identifier": "626001636",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6391611",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3850931",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4105358",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "626001636",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "626001636",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "168928",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.