Alexis May Kimble, D.O.

Primary specialty

Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X

License

20A16663 Issued in CA

Practice address

542 S Fair Oaks Ave FL 2
Pasadena, CA 91105

Phone

(626) 535-0832

Fax

(626) 535-0842

NPI assigned

Apr 29, 2009

Last updated

Dec 29, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: alexis.tran.1@19395.direct.athenahealth.com

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1952545220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "542 S FAIR OAKS AVE FL 2",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052606",
            "telephone_number": "162-653-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "542 S FAIR OAKS AVE FL 2",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "91105",
            "telephone_number": "626-535-0832",
            "fax_number": "626-535-0842"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Alessandro Pl Ste 420",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "91105",
            "country_code": "US",
            "telephone_number": "626-793-1710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMBLE",
        "first_name": "ALEXIS",
        "middle_name": "MAY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-29",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "20A16663",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "20A16663",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "CA",
            "license": "20A16663",
            "primary": true
        },
        {
            "code": "2088F0040X",
            "taxonomy_group": "",
            "desc": "Urology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "IL",
            "license": "36132170",
            "primary": false
        },
        {
            "code": "2088F0040X",
            "taxonomy_group": "",
            "desc": "Urology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "NY",
            "license": "286040",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marnetta Kimbell
• Kimberley I Shine M D Inc
• Kimberly a Ebner DDS Inc
• Kimberly Foon, DDS
• Kimberly J. Bozart, Physical Therapy, a Professional Corporation (Accelerated Sports Medicine & Physical Therapy)
• Bobby Nathaniel Kimble II
• David M Kimble, MD
• Kaylee Kimura, AUD
• Kind Kidney LLC
• Gina King-Lee

• Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.