Individual provider Active NPI

Kimberly L Miller, M.D.

  • Pediatrics Physician
  • Allen, TX
National Provider Identifier
1962454397
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
M1354 Issued in TX
Practice address
1256 W Exchange Pkwy Ste 200
Allen, TX 75013-7049
Phone
(972) 649-5480
Fax
(972) 649-6664
NPI assigned
May 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X M1354 TX Primary

Addresses

Primary practice location

1256 W Exchange Pkwy Ste 200
Allen, TX 75013-7049

Mailing address

1256 W Exchange Pkwy Ste 200
Allen, TX 75013-7049
Phone (972) 649-5480

Other practice location 1

2810 W 1st St Ste 30
Prosper, TX 75078-8151
Phone (469) 281-2388

Other names 1

  • Kimberly L Smith Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M1354TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Batb Pediatrics CurrentSince Aug 25, 2024 Accepting new patients
Lone Star Kids Care PastSince Aug 25, 2024 Accepting new patients
Brookwood Family Practice, P.a. PastSince Jun 18, 2012 Accepting new patients

Locations

1256 W Exchange Pkwy
Ste 200
Allen, TX 75013
Phone (972) 649-5480

Interoperability endpoints

  • Direct secure messaging: kim.smith@b-tx.direct.office.nextgen.com
  • FHIR API: https://api.platform.athenahealth.com/14040/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1962454397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1256 W EXCHANGE PKWY STE 200",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750137049",
            "telephone_number": "972-649-5480",
            "fax_number": "469-854-6664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1256 W EXCHANGE PKWY STE 200",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750137049",
            "telephone_number": "972-649-5480",
            "fax_number": "972-649-6664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2810 W 1st St Ste 30",
            "address_purpose": "LOCATION",
            "city": "Prosper",
            "state": "TX",
            "postal_code": "750788151",
            "country_code": "US",
            "telephone_number": "469-281-2388",
            "fax_number": "469-283-2489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KIMBERLY",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M1354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "SMITH",
            "middle_name": "L",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Allen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.