KIMBERLY RENAE GRABER PA-C NPI 1548490774

NPI Information

NPI: 1548490774
Provider Name: KIMBERLY RENAE GRABER, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
7250 CLEARVISTA DR
SUITE 210
INDIANAPOLIS, IN
ZIP 46256
Phone: (317) 621-5673
Get Directions

Kimberly Renae Graber, PA-C is a medical physician assistant in Indianapolis, IN with 15 years of experience. Kimberly Renae Graber, PA-C NPI is 1548490774. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

7250 CLEARVISTA DR
SUITE 210
INDIANAPOLIS, IN
ZIP 46256-692
Phone: (317) 621-5673
Fax: (317) 621-6040

The NPI 1548490774 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/22/2009 and was last updated on 11/27/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	10001107A	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	300005451	MEDICAID	INDIANA
2	000000781450	OTHER	INDIANA	ANTHEM
3	P01291564	OTHER	INDIANA	RAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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