MRS. KIMBERLY ALLISON GLIDEWELL (M.S., PA-C) – Physician Assistant, NPI 1124056189

MRS. KIMBERLY ALLISON GLIDEWELL (M.S., PA-C) is a healthcare provider. based in Caldwell, Texas. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials M.S., PA-C. They hold a License No. PA04405 (TX). The NPI Number for MRS. KIMBERLY ALLISON GLIDEWELL (M.S., PA-C) is 1124056189

Main info

Female
22 Years Of Experience
Accepts Medicare Assignment
Name
MRS. KIMBERLY ALLISON GLIDEWELL (M.S., PA-C)
NPI
1124056189
Phone
(979) 224-3866
Address
912 LOREY LN
Enumeration Date
29 June 2006
Last Update Date
25 September 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9368250000
Graduation Year
2004 (22 years ago)
PAC ID
3173660099
Group Practice PAC ID
4284542127
Professional Enrollment ID
I20091027000195
Address ID
TX778683248NA8310XLOOP400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

8,491 PHYSICIAN ASSISTANT in TX

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Provider Addresses for MRS. KIMBERLY ALLISON GLIDEWELL (M.S., PA-C)

  • 912, Lorey Lane, Caldwell, Burleson County, Texas, 77836, United States

    CALDWELL, TX 778361359

    Phone: (979) 224-3866

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $196.

Total Amount is formed as General ($196) + Research ($0) + Ownership ($0) = $196.

Last reported payment date: 2024-11-13 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($111).

Total Amount

$196

General + Research + Ownership

Payments

6

Total payment records

General Amount

$196

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-13

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-10-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20091027000195IPhysician AssistantTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 77836)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4284542127View full group profile
NameSpecialtyState
Nurse PractitionerTX
Osteopathic Manipulative Medicine, Family PracticeTX
Nurse PractitionerTX
Clinical Social WorkerWA
Nurse PractitionerTX
-TX
Family PracticeTX
Family PracticeTX
-TX
Nurse PractitionerTX

Reviews

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Frequently asked questions

What unique ID ties claims to MRS. KIMBERLY ALLISON GLIDEWELL (M.S., PA-C)?
NPI 1124056189 is assigned to MRS. KIMBERLY ALLISON GLIDEWELL (M.S., PA-C) under the national enumeration system.
Does this profile mean MRS. KIMBERLY ALLISON GLIDEWELL (M.S., PA-C) is currently active?
Yes — MRS. KIMBERLY ALLISON GLIDEWELL (M.S., PA-C) appears active in the national provider directory.
What does MRS. KIMBERLY ALLISON GLIDEWELL (M.S., PA-C) treat or focus on?
Patients typically see MRS. KIMBERLY ALLISON GLIDEWELL (M.S., PA-C) under the specialty Physician Assistant. Clinical services aligned with this taxonomy classification.
Where does public data place MRS. KIMBERLY ALLISON GLIDEWELL (M.S., PA-C)?
The snapshot lists Caldwell, Texas for MRS. KIMBERLY ALLISON GLIDEWELL (M.S., PA-C); download NPPES for the complete set.
How can I contact MRS. KIMBERLY ALLISON GLIDEWELL (M.S., PA-C)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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