Kimberly D'Eramo, D.O.

Individual provider Active NPI Public Health & General Preventive Medicine Physician · Hesperus, CO

NPI 1215037403 · NPPES record last updated Aug 17, 2016

Key facts

NPI
1215037403
Entity type
Individual (NPI type 1)
Primary specialty
Public Health & General Preventive Medicine Physician 2083P0901X
License
DR.0055899 (CO)
Practice address
1022 Heritage Rd
Hesperus, CO 81326-8709
Phone
(678) 602-0400
NPI assigned
Sep 25, 2006
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DR.0055899COMDPublic Health & General Preventive Medicine Physician
1837TNMDOrthopedic Physical Therapist

Practice roles

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

Specialties & licenses

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

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

IdentifierTypeStateIssuer
843825299BMedicaidGA

Other providers in Hesperus, CO

All providers in Hesperus, CO · Public Health & General Preventive Medicine Physician in Colorado

Sources for this page

Verify at the official NPI Registry.