Organization Active NPI

Robin R Potter-Kimball Aprn P C

  • Psychiatric/Mental Health Registered Nurse
  • Oklahoma City, OK
National Provider Identifier
1952508814
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
R0046325 Issued in OK
Legal business name
ROBIN R POTTER-KIMBALL APRN P C
Practice address
3208 NW 63Rd St
Oklahoma City, OK 73116-3704
Phone
(405) 286-4350
Fax
(405) 286-4361
NPI assigned
Jul 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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

Authorized official

Name
Robin Potter Kimball, CNSNPI 1841399904
Title
Owner
Phone
(405) 849-4682

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
Psychiatric/Mental Health Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WP0808X R0046325 OK Primary

Addresses

Primary practice location

3208 NW 63Rd St
Oklahoma City, OK 73116-3704

Mailing address

3208 NW 63Rd Street
Oklahoma City, OK 73116
Phone (405) 848-4682

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071005000297 OK Part B Supplier - Clinic/Group Practice 9739274713 Receives reassigned benefits from 1 practitioner
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Locations

3037 NW 63rd St
Ste 104
Oklahoma City, OK 73116
Phone (405) 286-4350

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670544000000",
    "number": "1952508814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3208 NW 63RD STREET",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73116",
            "telephone_number": "405-848-4682",
            "fax_number": "405-849-4683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3208 NW 63RD ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731163704",
            "telephone_number": "405-286-4350",
            "fax_number": "405-286-4361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBIN R POTTER-KIMBALL APRN P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-02",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A",
        "authorized_official_last_name": "POTTER KIMBALL",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-849-4682",
        "authorized_official_credential": "CNS"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OK",
            "license": "R0046325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; 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.