Individual provider Active NPI

Grace Marie Kimmerling

  • Mental Health Counselor
  • Muncie, IN
National Provider Identifier
1942871306
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1904 W Royale Dr
Muncie, IN 47304-2264
Phone
(765) 284-0043
NPI assigned
Jul 7, 2021
Last updated
Jul 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1904 W Royale Dr
Muncie, IN 47304-2264

Mailing address

1904 W Royale Dr
Muncie, IN 47304-2264
Phone (765) 284-0043

Other names 1

  • Grace Marie Yoder Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211026000233 IN Practitioner - Clinical Psychologist 7517355464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychological Assessment and Consulting, PCGroup PAC ID 3779646203, 2 clinicians

Practice addresses (Care Compare)

1806 W Royale Dr
Muncie, IN 47304-2243
Phone (765) 755-0052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Assessment and Consulting, PC CurrentSince Sep 30, 2022 Accepting new patients

Locations

1806 W Royale Dr
Muncie, IN 47304
Phone (765) 381-4578

Organizations & group practices 1

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": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1942871306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 W ROYALE DR",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473042264",
            "telephone_number": "765-284-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 W ROYALE DR",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473042264",
            "telephone_number": "765-284-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMMERLING",
        "first_name": "GRACE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACE",
            "last_name": "YODER",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Muncie, IN

Sources for this page

Verify at the official NPI Registry.