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KIMBERLY J PROUGH PAC NPI 1902811698


NPI Information

NPI: 1902811698
Provider Name: KIMBERLY J PROUGH, PAC
Classification: Physician Assistant - 363A00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
2254 HIGHWAY A1A
INDIAN HARBOUR BEACH, FL
ZIP 32937
Phone: (321) 777-2273
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Kimberly J Prough, PAC is a physician assistant in Indian Harbour Beach, FL with 23 years of experience. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. Kimberly J Prough, PAC NPI is 1902811698. 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:

2254 HIGHWAY A1A
INDIAN HARBOUR BEACH, FL
ZIP 32937-922
Phone: (321) 777-2273
Fax: (321) 779-7425

The NPI 1902811698 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 7/30/2006 and was last updated on 10/11/2016.


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
1363A00000XPhysician AssistantPA02977TEXASNo
2363A00000XPhysician AssistantPA9104973FLORIDAYes

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
18N8636OTHERTEXASBLUECROSS BLUESHIELD
2CE691WMEDICARE PINFLORIDA
38Y0826OTHERTEXASBLUE CROSS BLUE SHIELD
4Q34057MEDICARE UPIN
58D1531MEDICARE PINTEXAS
6P00246854MEDICARE PINTEXAS
78J3254MEDICARE PINTEXAS

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.