Individual provider Active NPI

Kimberly D'Eramo, D.O.

  • Public Health & General Preventive Medicine Physician
  • Hesperus, CO
National Provider Identifier
1215037403
Registry record updated Aug 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
DR.0055899 Issued in CO
Practice address
1022 Heritage Rd
Hesperus, CO 81326-8709
Phone
(678) 602-0400
NPI assigned
Sep 25, 2006
Last updated
Aug 17, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 239622 MA
Public Health & General Preventive Medicine Physician 2083P0901X DR.0055899 CO Primary

Addresses

Primary practice location

1022 Heritage Rd
Hesperus, CO 81326-8709

Mailing address

PO Box 957
Durango, CO 81302-0957
Phone (678) 602-0400

Other identifiers 1

IdentifierTypeStateIssuer
843825299BMedicaidGA

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
DR.0055899COMDPublic Health & General Preventive Medicine Physician
1837TNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage Services, PC Past Accepting new patients
Emergency Coverage, LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1215037403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 957",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813020957",
            "telephone_number": "678-602-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 HERITAGE RD",
            "city": "HESPERUS",
            "state": "CO",
            "postal_code": "813268709",
            "telephone_number": "678-602-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ERAMO",
        "first_name": "KIMBERLY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MA",
            "license": "239622",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "CO",
            "license": "DR.0055899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "843825299B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hesperus, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; 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.