DR. KENNETH S GIMBEL (NPI# 1881656502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881656502 |
| Entity Type | Individual |
| Full Name | DR. KENNETH S GIMBEL |
| Credential | MD |
| Practice Address |
6507 Professional Pl Riverdale GA 30274-4941 |
| Practice Telephone | 7709912100 |
| Practice Fax Number | 7709911180 |
| Mailing Telephone | 7709912100 |
| Mailing Fax Number | 7709911180 |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2008-02-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
018653 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
6507 PROFESSIONAL PL |
| City | RIVERDALE |
| State | GA |
| Zip Code | 30274-4941 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043219256 | Bhat Krishna Mohan | Specialist | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2005-07-19 |
| 1114574258 | Brittany Lynne Jackson | Nurse Practitioner | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2019-08-22 |
| 1154781714 | Kellie Michelle Noble | Nurse Practitioner | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2016-02-24 |
| 1861736803 | Dipti Khanna | Nurse Practitioner | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2012-11-15 |
| 1376768259 | Minnette Williams | Internal Medicine | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2007-04-16 |
| 1598852436 | Vikram Reddy Mandadi | Internal Medicine | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2006-10-10 |
| 1215049440 | Siva B Mohan | Internal Medicine | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2006-09-01 |
| 1639128531 | Southern Heart Specialists, P.C. | Internal Medicine | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2006-05-08 |
| 1265495444 | Kandathil M. Mathew | Internal Medicine | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2006-04-10 |
| 1659334829 | Devendra R Koganti | Internal Medicine | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2006-04-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245862507 | Todd L. Reed | Chiropractor | 83 Upper Riverdale Rd, Riverdale, GA 30274 | 2020-02-05 |
| 1487135992 | Freddie L Sallette IIi | Technician, Pathology | 385 Brookview Dr, Riverdale, GA 30274 | 2018-08-22 |
| 1366933210 | Dawn A. Paul | Nurse Practitioner | 238 Professional Ct Ste A, Riverdale, GA 30274 | 2018-05-27 |
| 1851894588 | Absolute Health Family & Urgent Care Clinic | Clinic/Center | 7574 Ga 85, Riverdale, GA 30274 | 2018-03-08 |
| 1366972127 | Jamillah Ingram | Physical Therapy Assistant | 315 Upper Riverdale Rd., Riverdale, GA 30274 | 2017-06-14 |
| 1114456514 | Grace L Kelson | Licensed Practical Nurse | 9142 Clubhouse Dr, Riverdale, GA 30274 | 2017-06-08 |
| 1790167799 | Cristian Carbuccia | Internal Medicine | 33 Upper Riverdale Rd Sw Ste 10, Riverdale, GA 30274 | 2015-06-25 |
| 1265857692 | Right Choice Enterprises LLC | Technician | 638 Sterling Ct, Riverdale, GA 30274 | 2014-02-21 |
| 1942571625 | Lowes Guardian Angel LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7056 Eunice Dr., Riverdale, GA 30274 | 2012-01-26 |
| 1508134156 | Education System Management, Inc | Social Worker | 125 Highway 138, Riverdale, GA 30274 | 2011-12-12 |
| Find all providers in zip 30274 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477500734 | Chituru Adele | Internal Medicine | 483 Upper Riverdale Rd Sw, Suite C, Riverdale, GA 30274-2584 | 2006-05-30 |
| 1336129840 | Tanveer A. Malik | Internal Medicine | 6504 Kenilworth Ave, Suite 200, Riverdale, MD 20737-1386 | 2006-01-19 |
| 1154795581 | Prime Healthcare Foundation - Southern Regional, LLC | Internal Medicine | 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 | 2015-11-23 |
| 1083897482 | Ashraf Md PC | Internal Medicine | 5711 Sarvis Ave, Suite#100, Riverdale, MD 20737-1394 | 2007-12-10 |
| 1376768259 | Minnette Williams | Internal Medicine | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2007-04-16 |
| 1700951563 | Georgia Heart Associates, PC | Internal Medicine | 33 Upper Riverdale Rd Sw, Suite 118, Riverdale, GA 30274-2626 | 2006-11-21 |
| 1720033392 | Kallukalam Joseph Mathew | Internal Medicine | 6504 Kenilworth Ave, Suite 200, Riverdale, MD 20737-1386 | 2006-05-23 |
| 1730132648 | Riverside Medical Associates Pa | Internal Medicine | 6502 Kenilworth Ave, Suite 100, Riverdale, MD 20737-1370 | 2006-05-19 |
| 1639128531 | Southern Heart Specialists, P.C. | Internal Medicine | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2006-05-08 |
| 1265495444 | Kandathil M. Mathew | Internal Medicine | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2006-04-10 |
| Find all providers in RIVERDALE | ||||
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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.