Individual provider Active NPI

Kimberly Crumbley Adkins, PA

  • Physician Assistant
  • Chattanooga, TN
National Provider Identifier
1972600393
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4808 Issued in TN
Practice address
975 E 3Rd St
Chattanooga, TN 37403-2173
Phone
(423) 778-7000
NPI assigned
Sep 20, 2006
Last updated
Mar 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X AP1949 MA
Physician Assistant 363A00000X 0110001947 VA
Physician Assistant 363A00000X PA.200347 LA
Physician Assistant 363A00000X 4808 TN Primary

Addresses

Primary practice location

975 E 3Rd St
Chattanooga, TN 37403-2173

Mailing address

975 E 3Rd St
Chattanooga, TN 37403-2173
Phone (423) 778-7000

Other identifiers 2

IdentifierTypeStateIssuer
04700372MedicaidMS
2115618MedicaidLA

Other names 1

  • Ms. Kimberly Renee Crumbley Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220609001599 TN Practitioner - Physician Assistant 1355306481 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erlanger HealthGroup PAC ID 1153780226, 504 clinicians

Practice addresses (Care Compare)

2600 Taft Hwy
Suite 100
Signal Mountain, TN 37377-2777
Phone (423) 778-9434

979 E 3Rd St
Chattanooga, TN 37403-2136

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4808TNMDCardiovascular Disease Physician
1949MAMDSports Medicine Podiatrist
PA.200347LAMDPhysician Assistant
AP1949MAMDPhysician Assistant
0110001947VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Erlanger Health CurrentSince Dec 17, 2023 Accepting new patients
Chattanooga Hamilton County Hospital Authority Past Accepting new patients
Neurologic Specialty Consulting LLC Past Accepting new patients

Locations

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

979 E 3rd St
Ste C225
Chattanooga, TN 37403
Phone (423) 778-5995

2600 Taft Hwy
Ste 100
Signal Mtn, TN 37377
Phone (423) 778-9434

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1972600393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 E 3RD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032173",
            "telephone_number": "423-778-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 E 3RD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032173",
            "telephone_number": "423-778-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADKINS",
        "first_name": "KIMBERLY",
        "middle_name": "CRUMBLEY",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "AP1949",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110001947",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA.200347",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "4808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04700372",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2115618",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "CRUMBLEY",
            "middle_name": "RENEE",
            "prefix": "MS.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.