Individual provider Active NPI

Kimberly A Marshall, M.D.

  • Obstetrics & Gynecology Physician
  • West Burlington, IA
National Provider Identifier
1225099302
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
34234 Issued in IA
Practice address
1223 S Gear Ave
Ste 208
West Burlington, IA 52655-1682
Phone
(319) 752-4541
Fax
(319) 752-2972
NPI assigned
Mar 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 34234 IA Primary

Addresses

Primary practice location

1223 S Gear Ave
Ste 208
West Burlington, IA 52655-1682

Mailing address

1223 S Gear Ave
Ste 208
West Burlington, IA 52655-1682
Phone (319) 752-4541

Other identifiers 3

IdentifierTypeStateIssuer
P00876866OtherIARAILROAD MEDICARE
1225099302OtherIAWELLMARK
1225099302MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040729000232 IA Practitioner - Obstetrics/Gynecology 0042280869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Southern Illinois University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Iowa Regional Medical Center IncGroup PAC ID 3870496417, 259 clinicians

Practice addresses (Care Compare)

1221 S Gear Ave
West Burlignton, IA 52655-1679
Phone (319) 768-1000

1223 S Gear Ave
Suite 208
West Burlington, IA 52655-1693
Phone (319) 768-2750

Hospital & facility affiliations

  • Southeast Iowa Regional Medical Center Hospital, West Burlington, IA, CCN 160057
  • Henry County Health Center Hospital, Mount Pleasant, IA, CCN 161356

Merit-based Incentive Payment System (MIPS)

Final score
77.06 of 100Reported as group
Quality
64.36
Promoting interoperability
81
Improvement activities
40
Cost
75.01

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34234IAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Great River Women'S Health Obstetrics & Gynecology Current Accepting new patients
Southeast Iowa Regional Medical Center, Inc. CurrentSince Jul 1, 2021 Accepting new patients
Southeast Iowa Regional Medical Center, Inc. Past Accepting new patients
Southeast Iowa Regional Medical Center, Inc. Past Accepting new patients

Locations

1221 S Gear Ave
West Burlington, IA 52655
Phone (319) 768-3622

1223 S Gear Ave
Ste 208
West Burlington, IA 52655
Phone (319) 752-4541

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352160000000",
    "number": "1225099302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 S GEAR AVE",
            "address_2": "STE 208",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551682",
            "telephone_number": "319-752-4541",
            "fax_number": "319-752-2972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 S GEAR AVE",
            "address_2": "STE 208",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551682",
            "telephone_number": "319-752-4541",
            "fax_number": "319-752-2972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2012-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IA",
            "license": "34234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00876866",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "1225099302",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225099302",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Burlington, IA

Sources for this page

Verify at the official NPI Registry.