Individual provider Active NPI

Kimberly Neumann, MD

  • Pediatrics Physician
  • Waterloo, IA
National Provider Identifier
1326023656
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
28834 Issued in IA
Practice address
905 Franklin St
Waterloo, IA 50703-4407
Phone
(319) 272-4300
NPI assigned
Dec 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 28834 IA Primary

Addresses

Primary practice location

905 Franklin St
Waterloo, IA 50703-4407

Mailing address

905 Franklin St
Waterloo, IA 50703-4407
Phone (319) 874-3000

Other identifiers 2

IdentifierTypeStateIssuer
08740OtherIAWELLMARK
0076372MedicaidIA

Other names 1

  • Kimberly Hansen Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@peoples-clinic.com Direct

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
I20100810000807 IA Practitioner - Pediatric Medicine 9234263476 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28834IAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peoples Community Health Clinic, Inc Current Accepting new patients
Peoples Community Health Clinic, Inc. CurrentSince Jul 1, 2010 Accepting new patients
Peoples Community Health Clinic, Inc CurrentSince Jul 1, 2010 Accepting new patients
Allen Memorial Hospital Corporation Past Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

905 Franklin St
Waterloo, IA 50703
Phone (319) 272-4300

Interoperability endpoints

  • Direct secure messaging: kneumann635106@direct.ochin.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1326023656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 FRANKLIN ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507034407",
            "telephone_number": "319-874-3000",
            "fax_number": "319-874-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 FRANKLIN ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507034407",
            "telephone_number": "319-272-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUMANN",
        "first_name": "KIMBERLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-09",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "28834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "08740",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0076372",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@peoples-clinic.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "905 Franklin St",
            "city": "Waterloo",
            "state": "IA",
            "country_code": "US",
            "postal_code": "507034407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "HANSEN",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.