Jim R. Kimbal, ATC, LAT, LMT, CSCS
NPI 1114985322ActiveIndividual· Specialist/Technologist, Athletic Trainer· Fairbanks, AK
Specialist/Technologist, Athletic Trainer (ATC, LAT, LMT, CSCS) in Fairbanks, Alaska, licensed in AK, UT and IL, with an NPI issued in May 2006.
Overview
| NPI | 1114985322 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | ATC, LAT, LMT, CSCS |
| Sole proprietor | Yes |
| NPI issued | May 4, 2006 |
| Last updated in NPPES | Sep 28, 2020 |
| Certified by provider | Sep 24, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Specialist/Technologist, Athletic Trainer Primary | 2255A2300X | 124560 | AK |
| Specialist/Technologist, Athletic Trainer | 2255A2300X | 10650493-4810 | UT |
| Massage Therapist | 225700000X | 227005348 | IL |
| Massage Therapist | 225700000X | 117476 | AK |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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