NPIMap

Organization Active NPI

Joel I Kimmel PHD PA

  • Clinical Psychologist
  • Coral Springs, FL
National Provider Identifier
1922179746
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY2344 Issued in FL
Legal business name
JOEL I KIMMEL PHD PA
Practice address
5551 N University Dr
Suite 102
Coral Springs, FL 33067-4651
Phone
(954) 755-2885
Fax
(954) 344-6007
NPI assigned
Nov 13, 2006
Last updated
Apr 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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

Authorized official

Name
Dr. Joel I Kimmel, PH.D.NPI 1487695029
Title
Psychologist
Phone
(954) 755-2885

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY2344 FL Primary

Addresses

Primary practice location

5551 N University Dr
Suite 102
Coral Springs, FL 33067-4651

Mailing address

5551 N University Dr
Suite 102
Coral Springs, FL 33067-4651
Phone (954) 755-2885

Other names 1

  • Joel I Kimmel PhD PA and Associates Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040915000304 FL Part B Supplier - Clinic/Group Practice 1759358161 Receives reassigned benefits from 5 practitioners
Practice locations: Coral Springs, FL

National Provider Directory

National Provider Directory

Locations

1890 N University Dr
Ste 302
Coral Springs, FL 33071
Phone (954) 752-4300

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208908800000",
    "number": "1922179746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5551 N UNIVERSITY DR",
            "address_2": "SUITE 102",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330674651",
            "telephone_number": "954-755-2885",
            "fax_number": "954-344-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5551 N UNIVERSITY DR",
            "address_2": "SUITE 102",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330674651",
            "telephone_number": "954-755-2885",
            "fax_number": "954-344-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOEL I KIMMEL PHD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2008-04-23",
        "status": "A",
        "authorized_official_last_name": "KIMMEL",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "954-755-2885",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY2344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Joel I Kimmel PhD PA and Associates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.