TRACI A. KIMBALL MD PC (NPI# 1326449646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326449646 |
| Entity Type | Organization |
| Organization Name | TRACI A. KIMBALL MD PC |
| Other Organization Name | WOUNDCARE INITIATIVES & SPECIALTY HEALTH |
| Practice Address |
4798 S Acoma St Englewood CO 80110-6541 |
| Practice Telephone | 7205600887 |
| Mailing Telephone | 7205600887 |
| Enumeration Date | 2014-09-05 |
| Last Update Date | 2020-03-27 |
| Authorized Official Name | TRACI A KIMBALL (CEO/FOUNDER) |
| Authorized Official Telephone | 7205600887 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251J00000X | Nursing Care | Agencies | ||
| N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities | ||
| N | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
Ambulatory Health Care Facilities | ||
| N | 261QR1100X |
Clinic/Center Specialization: Research |
Ambulatory Health Care Facilities | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 347C00000X | Private Vehicle | Transportation Services | ||
| N | 251E00000X | Home Health | Agencies | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 41180259 | 05 |
| Other Name | Type Code |
|---|---|
| Woundcare Initiatives & Specialty Health | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Traci A Kimball MD PC | 4798 S Acoma Street, Englewood, CO 80110 |
| Street Address |
4798 S ACOMA ST |
| City | ENGLEWOOD |
| State | CO |
| Zip Code | 80110-6541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841337110 | Traci A. Kimball | Nutritionist | 4798 S Acoma St, Englewood, CO 80110-6541 | 2007-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649803305 | Jamie Katherine Mcnair | Counselor | 3460 S. Sheridan Blvd., Sheridan, CO 80110 | 2020-02-20 |
| 1285152926 | Julie Sw Zhu | Nurse's Aide | 4141 S Navajo Street Apt 504a, Englewood, CO 80110 | 2017-09-01 |
| 1457878183 | Ryan Lynch | Counselor | 1455 Beeler St., Aurora, CO 80110 | 2017-08-24 |
| 1326565177 | Fredric M Sonstein Md Mba Pllc | Neurological Surgery | 333 W Hampden Ave Ste 800, Englewood, CO 80110 | 2017-08-23 |
| 1285160283 | No Smile Left Behind Pllc | Dentist | 750 W Hampden Avenue, Suite 516, Englewood, CO 80110 | 2017-05-11 |
| 1619369949 | Infinite Diagnostics, LLC | Clinical Medical Laboratory | 730 W Hamden Ave, Suite 200, Englewood, CO 80110 | 2015-02-24 |
| 1861833386 | Hospice Care of The Rockies LLC | Hospice Care, Community Based | 750 W Hampden Ave Ste 280, Englewood, CO 80110 | 2013-07-12 |
| 1336496470 | Michelle L Gambel | Physical Therapist | 401 W Hampden Pl Ste 10, Englewood, CO 80110 | 2012-08-08 |
| 1467729012 | Angela Johnson | Social Worker | 333 West Hampton Ave. Suite 705, Denver, CO 80110 | 2011-11-28 |
| 1881986479 | Angela Han Choi | Registered Nurse | 750 W Hampden Ave Ste 105, Englewood, CO 80110 | 2011-05-13 |
| Find all providers in zip 80110 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 1275570517 | Lemon Bay Physicians, P.a. | General Practice | 1885 Englewood Rd, Englewood, FL 34223-1822 | 2006-06-02 |
| 1245731140 | New Health Pain Treatment Centers, LLC | General Practice | 3277 S Lincoln St, Englewood, CO 80113-2512 | 2018-02-26 |
| 1144742016 | Denver Springs Physician Group LLC | General Practice | 8835 American Way, Englewood, CO 80112-7056 | 2017-07-12 |
| 1255738050 | Puremed LLC | General Practice | 200 Engle St, Englewood, NJ 07631-2440 | 2014-11-24 |
| 1053729319 | Vibrant Life Medicine, P.C. | General Practice | 286 Engle St, Englewood, NJ 07631-2405 | 2014-07-30 |
| 1922354943 | Nj Spine and Neuropathy Center | General Practice | 200 Engle St, Suite 21, Englewood, NJ 07631-2440 | 2012-07-27 |
| 1528342458 | Restorx | General Practice | 420 Valley View Rd, Englewood, NJ 07631-1621 | 2011-10-11 |
| 1295938025 | Melissa Trapp | General Practice | 2955 S Broadway, Englewood, CO 80113-1526 | 2007-06-08 |
| 1831229673 | Rebekah S Hansmeier | General Practice | 2955 S Broadway, Englewood, CO 80113-1526 | 2007-03-07 |
| Find all providers in ENGLEWOOD | ||||
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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.