Kimberly a Pummill MD PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

4301070280 Issued in MI

Legal business name

KIMBERLY A PUMMILL MD PC

Practice address

3595 Genesys Pkwy
Grand Blanc, MI 48439-7335

Phone

(810) 606-7888

NPI assigned

Oct 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kimberly Ann Pummill, MD

Title

Doctor

Phone

(810) 606-7888

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Grand Blanc Plastic Surgery Other name

Locations

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196121600000",
    "number": "1104005917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3595 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484397335",
            "telephone_number": "810-606-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3595 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484397335",
            "telephone_number": "810-606-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY A PUMMILL MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-29",
        "last_updated": "2007-11-27",
        "status": "A",
        "authorized_official_last_name": "PUMMILL",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "810-606-7888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301070280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS",
            "identifier": "0993473",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7319368",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0251130",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE",
            "identifier": "14465",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "6U4349",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Blanc Plastic Surgery",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Maxwell F Kilcoyne, DO
• Melissa Kimberly Kildow, NP
• Malyra Kilgore
• Timothy Michael Killian, LMSW
• SE Yeon Kim, DO
• Kimberly Sanderson PLLC
• Ian Kincade, PTA
• Laniyah Kincaid
• El Sheikh Eltayeb Ahmed Kineish, M.D.
• Nariyah King

• Specialist in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.