Individual provider Active NPI

Kristin Marie Yeoman, MD

  • Internal Medicine Physician
  • Chinle, AZ
National Provider Identifier
1043345234
Registry record updated Mar 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
30061 Issued in AZ
Practice address
Highway 191 and Hospital Road
Chinle, AZ 86503
Phone
(928) 674-7166
Fax
(928) 674-7705
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 30061 AZ Primary
Internal Medicine Physician 207R00000X M5984 TX

Addresses

Primary practice location

Highway 191 and Hospital Road
Chinle, AZ 86503

Mailing address

PO Box PH
Chinle, AZ 86503-8000
Phone (928) 674-7166

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140904001970 WA Practitioner - Internal Medicine 0143382267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
George Washington University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yakima Valley Farm Workers ClinicGroup PAC ID 4385541986, 274 clinicians

Practice addresses (Care Compare)

120 W Mission Ave
Spokane, WA 99201-2358
Phone (509) 326-4343

4001 N Cook St
Suite 900
Spokane, WA 99207-5879
Phone (509) 483-3427

713 Memorial St
Prosser, WA 99350-1524
Phone (509) 788-0485

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30061AZMDInternal Medicine Physician
M5984TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Farm Workers Clinic CurrentSince Sep 1, 2014 Accepting new patients
Yakima Valley Farm Workers Clinic Current Accepting new patients
Yakima Valley Farm Workers Clinic CurrentSince Sep 1, 2014 Accepting new patients

Locations

713 Memorial St
Prosser, WA 99350
Phone (509) 786-1931

4001 N Cook St
Ste 900
Spokane, WA 99207
Phone (509) 483-3427

Interoperability endpoints

  • Direct secure messaging: kyeoman10134@yvfwc.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299196800000",
    "number": "1043345234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX PH",
            "city": "CHINLE",
            "state": "AZ",
            "postal_code": "865038000",
            "telephone_number": "928-674-7166",
            "fax_number": "928-674-7705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HIGHWAY 191 AND HOSPITAL ROAD",
            "city": "CHINLE",
            "state": "AZ",
            "postal_code": "86503",
            "telephone_number": "928-674-7166",
            "fax_number": "928-674-7705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEOMAN",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2011-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "30061",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M5984",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chinle, AZ

Sources for this page

Verify at the official NPI Registry.