Kimberly Ming Chan, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD00046109 Issued in WA

Practice address

9800 Levin Rd NW
Suite 204
Silverdale, WA 98383-7856

Phone

(360) 613-1335

Fax

(360) 613-1329

NPI assigned

Nov 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IBADAA

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.

• Kitsap General Surgery PLLC

  • Surgery Physician
  • Silverdale, WA
  • NPI 1912010984

  Surgery

  NPD (past)

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265155200000",
    "number": "1194896779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9800 LEVIN RD NW",
            "address_2": "SUITE 204",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983837856",
            "telephone_number": "360-613-1335",
            "fax_number": "360-613-1329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9800 LEVIN RD NW",
            "address_2": "SUITE 204",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983837856",
            "telephone_number": "360-613-1335",
            "fax_number": "360-613-1329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "KIMBERLY",
        "middle_name": "MING",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2010-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD00046109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8466666",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cep America - Neurology PC
• Samantha Cerna, LMP
• Nathan Blake Chadwick, PA-C
• Mihaela Chamberlain
• Sarah Chamberlin, L.M.P.
• Scott Ernest Chandler, DO
• David S Chang, DO
• Chantel Monique Chapman, BCAT, RBT
• Charles K. Harvey D.D.S.
• Christopher Scott Chavarria, D.O.

• All providers in Silverdale, WA
• Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 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; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.