Deborah Kinnamon

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

01052369A Issued in IN

Practice address

820 N Samuel Moore Pkwy
Ste C
Mooresville, IN 46158-1467

Phone

(317) 483-5080

Fax

(317) 483-5085

NPI assigned

Jun 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Indiana University Health Care Associates, Inc

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1902032832
  Medicare reassignment NPD
• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777
  Medicare reassignment NPD
• University Family Physicians, Inc.

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1043275787
  Medicare reassignment NPD
• University Family Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Indianapolis, IN
  • NPI 1669828042
  NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• Methodist Medical Group Physicians Inc

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1285673616
  NPD (past)
• University Medical Diagnostic Associates, Inc.

  • Internal Medicine Physician
  • Indianapolis, IN
  • NPI 1861441537
  NPD (past)

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1093759102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 N SAMUEL MOORE PKWY",
            "address_2": "STE C",
            "city": "MOORESVILLE",
            "state": "IN",
            "postal_code": "461581467",
            "telephone_number": "317-483-5080",
            "fax_number": "317-483-5085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5550 S East St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462271979",
            "country_code": "US",
            "telephone_number": "317-890-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINNAMON",
        "first_name": "DEBORAH",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01052369",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01052369A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200294420",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dkinnamon@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "820 N Samuel Moore Pkwy",
            "address_2": "Ste C",
            "city": "Mooresville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461581467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amber Lee Kelley, PA-C
• Kendrick Regional Center for Colon and Rectal Care
• Kendrick Regional Center for Colon and Rectal Care
• Gregory J Kerr, MD
• Amy Jo King
• Kirkling Chiropractic Offices PC
• Kevin Corbin Kirkling, DC
• Dennis William Knierim, DDS
• Courtney Pauline Koharchick, MA CCC-SLP
• Kroger Limited Partnership I

• Pediatrics Physician in Mooresville, IN
• Providers in Mooresville, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.