Carl McCamey Kimbler, DMD MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

M862 Issued in SD

Practice address

820 1St Ave SE
Suite 400
Aberdeen, SD 57401-4601

Phone

(605) 225-9362

Fax

(605) 229-7317

NPI assigned

Dec 5, 2006

Sex

Male

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Nov 14, 2013 through Nov 14, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: drcarlkimbler@avera.sdhealthlink.net

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364169600000",
    "number": "1104984483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 1ST AVE SE",
            "address_2": "SUITE 400",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574014601",
            "telephone_number": "605-225-9362",
            "fax_number": "605-229-7317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 1ST AVE SE",
            "address_2": "SUITE 400",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574014601",
            "telephone_number": "605-225-9362",
            "fax_number": "605-229-7317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBLER",
        "first_name": "CARL",
        "middle_name": "MCCAMEY",
        "credential": "DMD MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2013-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SD",
            "license": "M862",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SD",
            "license": "SD4237",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41240",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0006084",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8000400",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hasan A Khan, MD
• Navaid A Khan, MD
• Sheilla Kiconco
• Suzie Kilber
• Russell Ivan Kimball, LMT
• Douglas J Kimmel, MD
• Wendy Kirkham, RPH
• Connor Michael Kirwan, PA-C
• George Craig Kiser, MD
• Sharon D Kissick

• Oral and Maxillofacial Surgery (Dentist) in Aberdeen, SD
• Providers in Aberdeen, SD by specialty
• Oral and Maxillofacial Surgery (Dentist) in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.