NPIMap

Individual provider Active NPI

Kimberly Carhuatanta, DO PHD

  • Family Medicine Physician
  • Lawrenceburg, IN
National Provider Identifier
1003445958
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02007463A Issued in IN
Practice address
98 Elm St
Lawrenceburg, IN 47025-2048
Phone
(812) 496-8775
Fax
(812) 537-5710
NPI assigned
Apr 3, 2020
Last updated
Oct 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02007463A IN Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

98 Elm St
Lawrenceburg, IN 47025-2048

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 344-5555

Other practice location 1

1100 Reid Pkwy
Richmond, IN 47374-1157
Phone (765) 935-8808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240312001709 IN Practitioner - Family Practice 7517388226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

98 Elm St
St Elizabeth Physicians
Lawrenceburg, IN 47025-2048
Phone (812) 537-9100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Feb 5, 2024 Accepting new patients
Summit Medical Group, Inc Family Medicine Current Accepting new patients
Summit Medical Group, Inc. Family Medicine CurrentSince Feb 5, 2024 Accepting new patients

Locations

204 Bridgeway St
Aurora, IN 47001
Phone (812) 926-3133

1640 Flossie Dr
Lawrenceburg, IN 47025
Phone (812) 496-3285

98 Elm St
Lawrenceburg, IN 47025
Phone (812) 496-8775

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1003445958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-344-5555",
            "fax_number": "859-344-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 ELM ST",
            "city": "LAWRENCEBURG",
            "state": "IN",
            "postal_code": "470252048",
            "telephone_number": "812-496-8775",
            "fax_number": "812-537-5710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Reid Pkwy",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "IN",
            "postal_code": "473741157",
            "country_code": "US",
            "telephone_number": "765-935-8808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARHUATANTA",
        "first_name": "KIMBERLY",
        "credential": "DO PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02007463A",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceburg, IN

Sources for this page

Verify at the official NPI Registry.