JON POTTER KIMBALL (NPI# 1205917374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205917374 |
| Entity Type | Individual |
| Full Name | JON POTTER KIMBALL |
| Credential | MD |
| Practice Address |
1988 Gulf To Bay Blvd Clearwater FL 33765-3550 |
| Practice Telephone | 7279538090 |
| Practice Fax Number | 7279538088 |
| Mailing Telephone | 7279538090 |
| Mailing Fax Number | 7279538088 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | ME96185 | FL | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | 2013-00103 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBSNC PROVIDER ID NUMBER | 177VX | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 120 William Penn Plz, Durham, NC 277042150 | 9192205255 | 9193131276 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053720565 | Jon Adam Kimball | Orthopaedic Surgery | 1520 San Pablo St Ste 2000, Los Angeles, CA 90033-5322 | 2014-08-08 |
| Street Address |
1988 GULF TO BAY BLVD |
| City | CLEARWATER |
| State | FL |
| Zip Code | 33765-3550 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851387476 | Ashraf Ahmed Ragab | Orthopaedic Surgery | 1988 Gulf To Bay Blvd, Clearwater, FL 33765-3550 | 2005-09-20 |
| 1316445877 | Amanda Michael Browne | Nurse Practitioner | 1988 Gulf To Bay Blvd, Clearwater, FL 33765-3550 | 2018-01-30 |
| 1225403520 | Comprehensive Anesthesia of Pinellas LLC | Anesthesiology | 1988 Gulf To Bay Blvd, Clearwater, FL 33765-3550 | 2015-12-11 |
| 1639549223 | Danielle Buchanan | Nurse Practitioner | 1988 Gulf To Bay Blvd, Clearwater, FL 33765 | 2015-09-25 |
| 1215247747 | Comprehensive Spine Institute, LLC | Specialist | 1988 Gulf To Bay Blvd, Clearwater, FL 33765-3550 | 2010-10-18 |
| 1902046493 | Mohit Bansal | Orthopaedic Surgery | 1988 Gulf To Bay Blvd, Clearwater, FL 33765-3550 | 2009-02-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023654449 | Seawa Enterprise LLC | Durable Medical Equipment & Medical Supplies | 1802 North Belcher Road, Suite 100, Clearwater, FL 33765 | 2019-11-20 |
| 1962996140 | Jeremy Scott Martin | Clinic/Center | 2481 N.e. Coachman Rd, Clearwater, FL 33765 | 2018-06-20 |
| 1891172078 | Comprehensive Surgery Center LLC | Clinic/Center | 407 Aurora Ave, Clearwater, FL 33765 | 2015-04-27 |
| 1184050411 | Anthony Richard Cheslock | Dentist | 1831 Belcher Road North, 1-b, Clearwater, FL 33765 | 2013-09-18 |
| 1548609522 | Andrew S Cormier | Optometrist | 2288 Drew Street, Suite B, Clearwater, FL 33765 | 2013-06-23 |
| 1124372412 | Kelly Ann Potts | Acupuncturist | 112 Evelyn Avenue, Clearwater, FL 33765 | 2012-11-08 |
| 1235402876 | Jerry N Karasick | Chiropractor | 901 N. Hercules Ave, Ste C, Clearwater, FL 33765 | 2012-02-13 |
| 1538329362 | Aei Diagnostic Imaging LLC | Clinic/Center | 1831 N Belcher Road, D Building, Clearwater, FLORIDA 33765 | 2008-06-16 |
| 1700053311 | Loredana Repetto | Social Worker | 2329 Sunset Point Road, Suite 203, Clearwater, FL 33765 | 2008-05-13 |
| 1679741920 | Kussel & Associates Inc. | Podiatrist | 2378 Sunset Point Rd, Clearwater, FL 33765 | 2008-02-20 |
| Find all providers in zip 33765 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356757512 | Michael Venezia | Orthopaedic Surgery | 1011 Jeffords St Bldg D, Clearwater, FL 33756-4070 | 2014-07-09 |
| 1467748533 | Gerard Lee Macdonald | Orthopaedic Surgery | 487 Island Way, Clearwater, FL 33767-2145 | 2011-06-27 |
| 1811126048 | Mitchell Ray Herrema | Orthopaedic Surgery | 1011 Jeffords St Bldg C, Clearwater, FL 33756 | 2009-07-09 |
| 1306041421 | Clearwater Orthopedic & Sports Medicine Inc | Orthopaedic Surgery | 701 N Hercules Ave Ste A, Clearwater, FL 33765-2029 | 2007-06-19 |
| 1649292046 | Andrew Wells Moulton | Orthopaedic Surgery | 2730 N Mcmullen Booth Rd Ste 202, Clearwater, FL 33761-3302 | 2006-07-24 |
| 1831137066 | Orthosports LLC | Orthopaedic Surgery | 3251 Mcmullen Booth Road, Suite 201, Clearwater, FL 33761 | 2006-06-02 |
| 1851387476 | Ashraf Ahmed Ragab | Orthopaedic Surgery | 1988 Gulf To Bay Blvd, Clearwater, FL 33765-3550 | 2005-09-20 |
| 1497749246 | Howard Louis Schuele | Orthopaedic Surgery | 1011 Jeffords St, Suite C, Clearwater, FL 33756-4070 | 2005-09-08 |
| 1053304022 | Robert Donnelly | Orthopaedic Surgery | 1660 Gulf To Bay Blvd, Clearwater, FL 33755 | 2005-08-25 |
| 1790778769 | Ronald G Hayter | Orthopaedic Surgery | 1831 N Belcher Rd Ste E2, E2, Clearwater, FL 33765-1442 | 2005-08-25 |
| Find all providers in CLEARWATER | ||||
| City | CLEARWATER |
| Zip Code | 33765 |
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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.