Kimberly Cronin, M.D.

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

MD20308 Issued in OR

Practice address

1515 Village Dr
Cottage Grove, OR 97424-9700

Phone

(541) 942-0511

Fax

(541) 942-0353

NPI assigned

Jun 20, 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

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 26, 2022 through Jan 26, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288742400000",
    "number": "1174569156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 569",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974400569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 VILLAGE DR",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "974249700",
            "telephone_number": "541-942-0511",
            "fax_number": "541-942-0353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRONIN",
        "first_name": "KIMBERLY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2010-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "OR",
            "license": "MD20308",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD20308",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084736",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cottage Grove SNF Healthcare LLC (Cottage Grove Post Acute)
• Covered Bridge Physical Therapy LLC
• Elizabeth A Cox
• Lily Mahala Cranor, MD
• Lezlee Vane Craven, LPC
• Anthony C Culver, QMHA, CNA
• Sean Keith Cummins
• Danielle Dahl, AT, LMT
• Janet Daum
• Ashley Le Compte Davis, FNP-C

• Emergency Medical Services (Emergency Medicine) Physician in Cottage Grove, OR
• Providers in Cottage Grove, OR by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2010; 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.