MR. NATHANIEL DALE KIMBALL MD
NPI 1194662395
Student in an Organized Health Care Education/Training Program in Waco, TX

Q: What is Nathaniel Kimball's NPI number?

The NPI number for Nathaniel Kimball is 1194662395. It was assigned to this individual provider in the NPPES registry on May 4, 2026.

Q: What is Nathaniel Kimball's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Nathaniel Kimball was last updated on May 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 04, 2026PECOS Enrolled

1600 PROVIDENCE DR, WACO, TX 76707(254) 313-4200(254) 313-4383 Get Directions Write a Review

NPPES record last updated: May 4, 2026. Verified against the NPPES registry weekly; last sync: September 13, 2026.

On this page

About Mr. Nathaniel Dale Kimball Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. NATHANIEL DALE KIMBALL MD (NPI 1194662395) is an individual student in an organized health care education/training program in Waco, Texas and active in the NPI registry since May 2026. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1194662395

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameMR. NATHANIEL DALE KIMBALLCredential: MD

Location Address1600 PROVIDENCE DRWaco, TX 76707-2261

Mailing Address906 Xavier St Unit 2Lubbock, TX 79403-1823 · (254) 313-4200 · Fax (254) 313-4383

Phone(254) 313-4200

Fax(254) 313-4383

Sole ProprietorNo

Enumeration DateMay 4, 2026

NPPES CertifiedMay 4, 2026

✔ NPI 1194662395 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1600 PROVIDENCE DR, Waco, TX 76707

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Nathaniel Dale Kimball Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALLISON L HULME MD

Family Medicine