Active NPI
Kevin J Chismire, M.D.
- Ophthalmology Physician
- Montrose, CO
National Provider Identifier
1184776114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 27759
- Practice address
- 1800 E. Pavilion Place
Suite B
Montrose, CO 81401 - Phone
- (970) 249-1210
- Fax
- (970) 249-3057
- NPI assigned
- Jan 18, 2007
- Last updated
- Oct 30, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 27759 | CO | Primary |
Addresses
Primary practice location
1800 E. Pavilion Place
Suite B
Montrose, CO 81401
Mailing address
1800 E. Pavilion Place
Suite B
Montrose, CO 81401
Phone (970) 249-1210
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 667552 | Other | BLUECROSS BLUESHIELD | |
| 54774845 | Medicaid | CO | |
| 840851676006 | Other | ROCKY MOUNTAIN HEALTH PLA | |
| P00094915 | Other | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193702400000",
"number": "1184776114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 E. PAVILION PLACE",
"address_2": "SUITE B",
"city": "MONTROSE",
"state": "CO",
"postal_code": "81401",
"telephone_number": "970-249-1210",
"fax_number": "970-249-3057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 E. PAVILION PLACE",
"address_2": "SUITE B",
"city": "MONTROSE",
"state": "CO",
"postal_code": "81401",
"telephone_number": "970-249-1210",
"fax_number": "970-249-3057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHISMIRE",
"first_name": "KEVIN",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-18",
"last_updated": "2007-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "CO",
"license": "27759",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "667552",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "54774845",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ROCKY MOUNTAIN HEALTH PLA",
"identifier": "840851676006",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00094915",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Montrose, CO
- Chayjay LLC
- Chayjay LLC Dba Mountain Peaks Urgent Care
- Chayjay LLC Dba Mountain Peaks Urgent Care
- Kathy Lee Cherry, LMT
- Children's Hospital Colorado (Children's Colorado Regional Outreach Clinic - Montrose - PAM)
- Cimarron Dental Hygiene
- CJ Medical Transportation
- Daniel T Clader, DDS
- Thomas A Clagett, MD
- Shara Clark
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.