DR. KELLY L WIMBERLY (NPI# 1053330803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053330803 |
| Entity Type | Individual |
| Full Name | DR. KELLY L WIMBERLY |
| Credential | MD |
| Practice Address |
17101 Preston Rd Suite 200 Dallas TX 75248-1331 |
| Practice Telephone | 9722394441 |
| Practice Fax Number | 9722391597 |
| Mailing Telephone | 9722394441 |
| Mailing Fax Number | 9722391597 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2011-09-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | J3002 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | MEDICARE RR GROUP NUMBER | DH1426 | 01 |
| TX | MEDICARE RR PIN | P00474586 | 01 |
| Street Address |
17101 PRESTON RD SUITE 200 |
| City | DALLAS |
| State | TX |
| Zip Code | 75248-1331 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174549406 | Aimee L Wright Do Pa | Family Medicine | 17101 Preston Rd, Suite 200, Dallas, TX 75248-1331 | 2006-07-13 |
| 1326415779 | Pediaq Texas LLC | Nurse Practitioner | 17101 Preston Rd, Ste 115, Dallas, TX 75248-1331 | 2015-09-01 |
| 1477938132 | Pediaq | Nurse Practitioner | 17101 Preston Rd, Ste 115, Dallas, TX 75248-1331 | 2015-07-23 |
| 1992013239 | Jeannette Larue Kilgard | Physician Assistant | 17101 Preston Rd, Suite 200, Dallas, TX 75248-1331 | 2010-09-21 |
| 1033383518 | Keli S. Jones M.d., Pa | Obstetrics & Gynecology | 17101 Preston Rd, Suite 200, Dallas, TX 75248-1331 | 2008-04-16 |
| 1093845349 | Keli Jones | Obstetrics & Gynecology | 17101 Preston Rd, Suite 200, Dallas, TX 75248-1331 | 2007-03-06 |
| 1881616860 | Brandon Marshall Bonds | Chiropractor | 17101 Preston Rd, #190, Dallas, TX 75248 | 2006-07-25 |
| 1578589842 | Kelly L Wimberly Md Pa | Family Medicine | 17101 Preston Rd, Suite 200, Dallas, TX 75248-1331 | 2006-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093336398 | Rachel Carrithers | Registered Nurse | 7611 El Pendsador, Dallas, TX 75248 | 2020-04-28 |
| 1538621024 | Syreeta Williams | Specialist | 16690 Dallas Parkway, Suite 208, Dallas, TX 75248 | 2019-04-03 |
| 1225505928 | Bent Tree Counseling, Pllc | Marriage & Family Therapist | 16800 North Dallas Parkway, Suite 100, Dallas, TX 75248 | 2018-10-31 |
| 1649764598 | Annie Girson | Dentist | 16000 Preston Rd. Suite 310, Dallas, TX 75248 | 2018-06-14 |
| 1821503772 | Affordable Dentist Near Me Dallas Pllc. | Dentist | 14902 Preston Road. Suite 201, Dallas, TX 75248 | 2017-12-13 |
| 1477077717 | Children's Dental At Preston Trail, PC | Dentist | 17194 Preson Road, Dallas, TX 75248 | 2017-07-28 |
| 1871023481 | Caroline Ford | Psychologist | 16150 Preston Road, Dallas, TX 75248 | 2017-06-15 |
| 1679940902 | North Texas Cin, Inc. | Clinic/Center | 15770 North Dallas Parkway, Suite 900, Dallas, TX 75248 | 2015-08-21 |
| 1508246240 | Arzu Shams | Counselor | 17103 Preston Rd Ste 230, Dallas, TX 75248 | 2015-06-08 |
| 1992182174 | Texas Dentistry for Kids Richardson, Pllc | Dentist | 7989 Beltline Rd Ste# 107, Dallas, TX 75248 | 2015-04-27 |
| Find all providers in zip 75248 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245853811 | Forest Family Clinic, LLC | Family Medicine | 9550 Forest Ln Suite 606, Dallas, TX 75243-5905 | 2020-05-18 |
| 1104447937 | Centenary Family & Urgent Care | Family Medicine | 8702 S Lancaster Rd Ste 160a, Dallas, TX 75241-6301 | 2020-05-04 |
| 1285274456 | Genesis Health Partners Pllc | Family Medicine | 8390 Lbj Fwy Ste 1000b, Dallas, TX 75243-1188 | 2020-01-15 |
| 1194368266 | Sierra Healthcare Network LLC | Family Medicine | 2727 Lbj Fwy Ste 326, Dallas, TX 75234-7478 | 2019-10-22 |
| 1184274896 | Matilda N Nju | Family Medicine | 41 Kelso Way, Dallas, GA 30132-2618 | 2019-09-14 |
| 1992366488 | Anmd Health Pllc | Family Medicine | 1910 Pacific Ave Suite 15700, Dallas, TX 75201 | 2019-06-25 |
| 1366908600 | Advanced Wound Care of North Texas Pllc | Family Medicine | 13154 Coit Rd Ste 102d, Dallas, TX 75240-5787 | 2019-02-12 |
| 1932664935 | Environmental Health Center - North Texas Pa | Family Medicine | 8345 Walnut Hill Ln Ste 220, Dallas, TX 75231-4205 | 2019-02-04 |
| 1679043723 | Inwood Medical Clinic Inc. | Family Medicine | 2916 Inwood Rd, Dallas, TX 75235-7518 | 2018-12-03 |
| 1134698939 | Cayla Schaner | Family Medicine | 3600 Gaston Ave Ste 1109, Dallas, TX 75246-1811 | 2018-11-21 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.