KIMALISA KAY SHAMBLIN (NPI# 1982909800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982909800 |
| Entity Type | Individual |
| Full Name | KIMALISA KAY SHAMBLIN |
| Credential | BA, RT(R)(CT), RVT |
| Practice Address |
428 Division St South Charleston WV 25309-1469 |
| Mailing Address |
374 Wildlife Way Clendenin WV 25045-5193 |
| Practice Telephone | 3047669617 |
| Mailing Telephone | 3042061420 |
| Enumeration Date | 2011-01-25 |
| Last Update Date | 2011-01-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 246XS1301X |
Spec/Tech, Cardiovascular Specialization: Sonography |
1540 | WV | Technologists, Technicians & Other Technical Service Providers |
| N | 247100000X | Radiologic Technologist | 1540 | WV | Technologists, Technicians & Other Technical Service Providers |
| Y | 2471C3401X |
Radiologic Technologist Specialization: Computed Tomography |
1540 | WV | Technologists, Technicians & Other Technical Service Providers |
| N | 2471C3402X |
Radiologic Technologist Specialization: Radiography |
1540 | WV | Technologists, Technicians & Other Technical Service Providers |
| N | 2471S1302X |
Radiologic Technologist Specialization: Sonography |
1540 | WV | Technologists, Technicians & Other Technical Service Providers |
| N | 2471V0105X |
Radiologic Technologist Specialization: Vascular Sonography |
1540 | WV | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
428 DIVISION ST |
| City | SOUTH CHARLESTON |
| State | WV |
| Zip Code | 25309-1469 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578620696 | Badshah J. Wazir | Specialist | 428 Division St, South Charleston, WV 25309-1469 | 2007-01-02 |
| 1578922878 | Activate Healthcare - Teamsters 175 & 505 Clinic | Clinic/Center | 428 Division St, Suite 2, South Charleston, WV 25309-1469 | 2016-02-15 |
| 1609216605 | Pediatric Gastroenterology of Charleston, Pllc | Pediatrics | 428 Division St, Suite 3a, South Charleston, WV 25309-1469 | 2013-07-05 |
| 1770706772 | South Charleston Cardiology Associates | Specialist | 428 Division St, South Charleston, WV 25309-1469 | 2007-04-10 |
| 1407079304 | South Charleston Cardiodiagnostics | Clinical Medical Laboratory | 428 Division St, 1st Floor, South Charleston, WV 25309-1469 | 2007-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699376905 | Lovie Bradshaw | Technician | 4823 Tennessee St., South Charleston, WV 25309 | 2020-11-03 |
| 1306447735 | Barbara Mackenzie | Technician | 4224 Kanawha Turnpike, South Charleston, WV 25309 | 2020-11-03 |
| 1548861974 | Sarah Nichols | Technician | 4990 Colonial Park Dr. Apt. F, South Charleston, WV 25309 | 2020-11-03 |
| 1629690177 | Jennifer Mabry-goins | Technician | 4505 River Avenue, S Charleston, WV 25309 | 2020-05-07 |
| 1811537715 | Brandon C Dean | Psychologist | 4857 Macorkle Ave. Sw, South Charleston, WV 25309 | 2020-01-09 |
| 1467096057 | Linda Mullins | Technician | 60 Hayvon Lane, South Charleston, WV 25309 | 2019-11-06 |
| 1831743616 | Ann Myriah Beck | Nurse Practitioner | 4610 Maccorkle Ave Sw # 300, South Charleston, WV 25309 | 2019-07-30 |
| 1942671227 | Edward W Eskew | Family Medicine | 4605 Maccorkle Avenue, Sw, Thspp-psychiatry, South Charleston, WV 25309 | 2015-10-13 |
| 1720468218 | Link Investments LLC | Pharmacy | 5151 Macorkle Avenue, South Charleston, WV 25309 | 2015-06-01 |
| 1366840951 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 304 Southbridge Blvd., S.ccharleston, WV 25309 | 2014-12-12 |
| Find all providers in zip 25309 | ||||
| Taxonomy Code | 2471C3401X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| Specialization | Computed Tomography |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609249556 | James Anthony Altman | Radiologic Technologist | 53 Natural Way, Martinsburg, WV 25404-3780 | 2015-11-01 |
| 1831347285 | Andrew Lee Burleson | Radiologic Technologist | 407 Washington Ave, Crab Orchard, WV 25827-9598 | 2008-08-28 |
| City | SOUTH CHARLESTON |
| Zip Code | 25309 |
Please comment or provide details below to improve the information on KIMALISA KAY SHAMBLIN.
| 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.