Ieshia Kimble, PMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Lavon, Texas. Her current practice location is
479 Coolidge Ln, Lavon, Texas. You can reach out to her office (for appointments etc.) via phone at
(414) 520-7156.
Ieshia Kimble is licensed to practice in Texas (license number 1071306) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1124774500.
Provider's Profile
| Full Name | Ieshia Kimble |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Psychiatric/mental Health |
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| Location | 479 Coolidge Ln, Lavon, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1124774500
- Provider Enumeration Date: 02/24/2022
- Last Update Date: 02/24/2022
Medicare PECOS Information:
- PECOS PAC ID: 3173995719
- Enrollment ID: I20230208002596
Medical Identifiers
Medical identifiers for Ieshia Kimble such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1124774500 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 1071306 (Texas) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ieshia Kimble allows following entities to bill medicare on her behalf.
| Entity Name | Senior Psychcare Of Dallas I Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1942596903
PECOS PAC ID: 2466625371
Enrollment ID: O20111109000103 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ieshia Kimble is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Ieshia Kimble, PMHNP
479 Coolidge Ln,
Lavon, TX 75166-1694
Ph: (414) 520-7156 | Ieshia Kimble, PMHNP
479 Coolidge Ln,
Lavon, TX 75166-1694
Ph: (414) 520-7156 |
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