Individual provider Active NPI

Kimberly Parkerson, NP

  • Nurse Practitioner
  • Bryan, TX
National Provider Identifier
1932904810
Registry record updated Feb 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1191077 Issued in TX
Practice address
3121 University Dr E Ste 100
Bryan, TX 77802-3499
Phone
(979) 776-0169
Fax
(979) 776-1372
NPI assigned
Feb 15, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1191077 TX Primary

Addresses

Primary practice location

3121 University Dr E Ste 100
Bryan, TX 77802-3499

Mailing address

3121 University Dr E Ste 100
Bryan, TX 77802-3499
Phone (979) 776-0169

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250402002330 TX Practitioner - Nurse Practitioner 7214450014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brazos Valley Physicians AllianceGroup PAC ID 1052604006, 22 clinicians

Practice addresses (Care Compare)

3121 University Dr E
100 Central Texas Sports Medicine and Ort
Bryan, TX 77802-3499
Phone (979) 776-0169

Hospital & facility affiliations

  • Physicians Centre,the Hospital, Bryan, TX, CCN 450834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1191077TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brazos Valley Physicians Alliance CurrentSince Mar 18, 2025 Accepting new patients
Brazos Valley Physicians Alliance CurrentSince Mar 18, 2025 Accepting new patients

Locations

3121 University Dr E
Ste 100
Bryan, TX 77802
Phone (979) 776-0169

3201 University Dr E
Ste 455
Bryan, TX 77802
Phone (979) 704-5029

3201 University Dr E
Ste 3
Bryan, TX 77802
Phone (979) 704-5029

Interoperability endpoints

  • Direct secure messaging: kimberly.parkerson.1@25466.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1739577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739577600000",
    "number": "1932904810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3121 UNIVERSITY DR E STE 100",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023499",
            "telephone_number": "979-776-0169",
            "fax_number": "979-776-1372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3121 UNIVERSITY DR E STE 100",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023499",
            "telephone_number": "979-776-0169",
            "fax_number": "979-776-1372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKERSON",
        "first_name": "KIMBERLY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-15",
        "last_updated": "2025-02-15",
        "certification_date": "2025-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1191077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.