Kyle W Kimbrough (NPI# 1104231695, PAC ID# 1052630092) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1104231695 |
| PAC ID by PECOS | 1052630092 |
| Professional Enrollment ID | I20150424001670 |
| Full Name | Kyle W Kimbrough |
| Organization Legal Name | PRIMARY CARE GROUP, LLC |
| Address |
7235 Hacks Cross Rd Olive Branch MS 38654-4213 |
| Phone Number | 6628937878 |
| Gender | M |
| Graduation Year | 2014 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 0941480131 |
| Number of Group Practice Members | 94 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 250167 | METHODIST HEALTHCARE - OLIVE BRANCH HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 7235 Hacks Cross Rd, Olive Branch, MS 38654-4213 | 6628937878 | PRIMARY CARE GROUP, LLC |
| 5908 Getwell Rd, Southaven, MS 38672-7317 | 6625364646 | PRIMARY CARE GROUP, LLC |
| Organization Legal Name | PRIMARY CARE GROUP, LLC |
| Physicians | 100 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bonnie L Barnes | Family Medicine | Primary Care Group, LLC | 3725 Champion Hills Dr, Suite 2000, Memphis, TN 38125-0502 |
| Penina Danziger | Nurse Practitioner | Primary Care Group, LLC | 6570 Summer Oaks Cv, Bartlett, TN 38134-2857 |
| Nora E Maldonado | Family Medicine | Primary Care Group, LLC | 9047 Poplar Ave, Suite 105, Germantown, TN 38138-6401 |
| Jeffrey E Banham | Nurse Practitioner | Primary Care Group, LLC | 2589 Appling Rd, Suite 101, Bartlett, TN 38133-5099 |
| Regina Forbess Goulder | Nurse Practitioner | Primary Care Group, LLC | 76 Capital Way, Suite C, Atoka, TN 38004-6832 |
| Jennifer C Sanders | Nurse Practitioner | Primary Care Group, LLC | 7163 Goodman Rd, Olive Branch, MS 38654-1904 |
| Michelle D Kitson | Internal Medicine | Primary Care Group, LLC | 5182 Sanderlin Ave, Suite 3, Memphis, TN 38117-4354 |
| Julie W Crafton | Nurse Practitioner | Primary Care Group, LLC | 7690 Wolf River Circle, Germantown, TN 38138-1744 |
| Lee Wilkes Mccallum | Family Medicine | Primary Care Group, LLC | 8115 Country Village Dr, Suite 105, Cordova, TN 38016-2030 |
| Mark L Reed | General Practice | Primary Care Group, LLC | 1211 Union Ave, Suite 700, Memphis, TN 38104-6600 |
| Street Address |
7235 HACKS CROSS RD |
| City | OLIVE BRANCH |
| State | MS |
| Zip | 38654-4213 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Walter E Carnahan | Family Medicine | Primary Care Group, LLC | 7235 Hacks Cross Rd, Olive Branch, MS 38654-4213 |
| Laxmisilpa G Hansen | Obstetrics/gynecology | Primary Care Group, LLC | 7235 Hacks Cross Rd, Olive Branch, MS 38654-4213 |
| Susan A Scott | Nurse Practitioner | Primary Care Group, LLC | 7235 Hacks Cross Rd, Olive Branch, MS 38654-4213 |
| Patricia Leanne Lewis | Nurse Practitioner | Primary Care Group, LLC | 7235 Hacks Cross Rd, Olive Branch, MS 38654-4213 |
| Ashley P Salvaggio | Family Medicine | Primary Care Group, LLC | 7235 Hacks Cross Rd, Olive Branch, MS 38654-4213 |
| William H Mcclatchy | Family Medicine | Primary Care Group, LLC | 7235 Hacks Cross Rd, Olive Branch, MS 38654-4213 |
| Dabney J Hamner | Obstetrics/gynecology | Primary Care Group, LLC | 7235 Hacks Cross Rd, Olive Branch, MS 38654-4213 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nathan Musso | Physical Therapy | Agilitas Usa Inc | 8110 Camp Creek Rd, Suite 106, Olive Branch, MS 38654-1622 |
| Clare E Benson | Physical Therapy | Agilitas Usa Inc | 8110 Camp Creek Rd, Suite 106, Olive Branch, MS 38654-1622 |
| Shavon Conerly | Physical Therapy | Agilitas Usa Inc | 8110 Camp Creek Rd, Suite 106, Olive Branch, MS 38654-1622 |
| Steven Hopkins | Physical Therapy | Agilitas Usa Inc | 8110 Camp Creek Rd, Suite 106, Olive Branch, MS 38654-1622 |
| Nicholas Bailey | Physical Therapy | Agilitas Usa Inc | 8110 Camp Creek Rd, Suite 106, Olive Branch, MS 38654-1622 |
| Emily Michele Terrell | Physical Therapy | Agilitas Usa Inc | 8110 Camp Creek Rd, Suite 106, Olive Branch, MS 38654-1622 |
| John H Desutter | Chiropractic | 9659 Goodman Rd, Olive Branch, MS 38654-1725 | |
| Vickie D Long | Nurse Practitioner | 9684 Old Goodman Rd, Olive Branch, MS 38654-1726 | |
| Jennifer C Sanders | Nurse Practitioner | Primary Care Group, LLC | 7163 Goodman Rd, Olive Branch, MS 38654-1904 |
| Shailesh Patel | Internal Medicine | Primary Care Group, LLC | 7163 Goodman Rd, Olive Branch, MS 38654-1904 |
| Find all physicians in zip 38654 | |||
| City | OLIVE BRANCH |
| Zip Code | 38654 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | OLIVE BRANCH + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Kyle W Kimbrough.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.