Active NPI
Herman Kimball
- Gerontology Registered Nurse
- Durham, NC
National Provider Identifier
1972014553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Registered Nurse
- License
- 249835
- Practice address
- 807 S Duke St
Durham, NC 27701-3975 - Phone
- (919) 596-5386
- Fax
- (919) 680-2955
- NPI assigned
- Oct 23, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Registered Nurse | 163WG0600X | 249835 | NC | Primary |
Addresses
Primary practice location
807 S Duke St
Durham, NC 27701-3975
Mailing address
807 S Duke St
Durham, NC 27701-3975
Phone (919) 596-5386
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 249835 | NC | MD | Gerontology Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508716800000",
"number": "1972014553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "807 S DUKE ST",
"city": "DURHAM",
"state": "NC",
"postal_code": "277013975",
"telephone_number": "919-596-5386",
"fax_number": "919-680-2955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "807 S DUKE ST",
"city": "DURHAM",
"state": "NC",
"postal_code": "277013975",
"telephone_number": "919-596-5386",
"fax_number": "919-680-2955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMBALL",
"first_name": "HERMAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-10-23",
"last_updated": "2017-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "163WG0600X",
"taxonomy_group": "",
"desc": "Registered Nurse, Gerontology",
"state": "NC",
"license": "249835",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.