Individual provider Active NPI

David Michael Kimball, DO

  • Student in an Organized Health Care Education/Training Program
  • Lancaster, OH
National Provider Identifier
1063261865
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
135 N Ewing St Ste 304
Lancaster, OH 43130-3379
Phone
(740) 687-8397
Fax
(740) 654-4103
NPI assigned
May 14, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

135 N Ewing St Ste 304
Lancaster, OH 43130-3379

Mailing address

135 N Ewing St Ste 304
Lancaster, OH 43130-3379
Phone (740) 687-8397

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240814005112 OH Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4486192952

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1715644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1063261865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 N EWING ST STE 304",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303379",
            "telephone_number": "740-687-8397",
            "fax_number": "740-654-4103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 N EWING ST STE 304",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303379",
            "telephone_number": "740-687-8397",
            "fax_number": "740-654-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-14",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

Verify at the official NPI Registry.