Lawrence Dustin Kimball III, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101010860 Issued in MI

Practice address

451 Hidden Meadows Dr
Suite 120
Hillsdale, MI 49242-9812

Phone

(517) 437-0010

Fax

(517) 437-0319

NPI assigned

Jul 8, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Family PracticeAlso: Osteopathic Manipulative Medicine

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elara Caring Home health agency, Jackson, MI, CCN 237274
• Hospice of Hillsdale County Hospice, Hillsdale, MI, CCN 231552
• Elara Caring Hospice, Bingham Farms, MI, CCN 231579
• Hillsdale Hospital Hospital, Hillsdale, MI, CCN 230037
• Hillsdale County Medical Care Facility Nursing home, Hillsdale, MI, CCN 235197
• Hillsdale Hospital McGuire & Macritchie Long Term Nursing home, Hillsdale, MI, CCN 235567

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: l.dustin.kimball.1@3688.direct.athenahealth.com

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• County of Hillsdale

  dba Hillsdale County Medical Care Facility

  • Skilled Nursing Facility
  • Hillsdale, MI
  • NPI 1568449684

  Adp of the SNF, Contracted Managing Employee

  CMS ownership

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.

• LDK III Holdings, LLC

  • Family Medicine Physician
  • Hillsdale, MI
  • NPI 1073929089
  Medicare reassignment NPD Authorized official
• Karen Lindower DO PLLC

  • Family Medicine Physician
  • Hillsdale, MI
  • NPI 1669991543
  NPD
• County of Hillsdale

  dba Hillsdale County Medical Care Facility

  • Skilled Nursing Facility
  • Hillsdale, MI
  • NPI 1568449684
  NPD (past)
• Hillsdale Community Health Center

  • Skilled Nursing Facility
  • Hillsdale, MI
  • NPI 1538262886
  NPD (past)
• Hillsdale Community Health Center

  dba Hillsdale Hospital

  • General Acute Care Hospital
  • Hillsdale, MI
  • NPI 1730115940
  NPD (past)

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

• County of Hillsdale

  dba Hillsdale County Medical Care Facility

  • Skilled Nursing Facility
  • Hillsdale, MI
  • NPI 1568449684

  Nursing home

  Care Compare affiliation
• Great Lakes Home Health Services, Inc.

  dba Elara Caring

  • Home Health Agency
  • Jackson, MI
  • NPI 1588642110
  Care Compare affiliation
• Hillsdale Community Health Center

  • Skilled Nursing Facility
  • Hillsdale, MI
  • NPI 1538262886

  Nursing home

  Care Compare affiliation
• Hillsdale Community Health Center

  dba Hillsdale Hospital

  • General Acute Care Hospital
  • Hillsdale, MI
  • NPI 1730115940
  Care Compare affiliation
• Hospice of Hillsdale County

  • Community Based Hospice Care Agency
  • Hillsdale, MI
  • NPI 1831199298
  Care Compare affiliation
• Op Hospice, LLC

  dba Elara Caring

  • Community Based Hospice Care Agency
  • Bingham Farms, MI
  • NPI 1750526620
  Care Compare affiliation

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397433600000",
    "number": "1346248937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 HIDDEN MEADOWS DR",
            "address_2": "SUITE 120",
            "city": "HILLSDALE",
            "state": "MI",
            "postal_code": "492429812",
            "telephone_number": "517-437-0010",
            "fax_number": "517-437-0319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 HIDDEN MEADOWS DR",
            "address_2": "SUITE 120",
            "city": "HILLSDALE",
            "state": "MI",
            "postal_code": "492429812",
            "telephone_number": "517-437-0010",
            "fax_number": "517-437-0319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "LAWRENCE",
        "middle_name": "DUSTIN",
        "name_suffix": "III",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2014-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101010860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0153000035",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2935031",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GLHP",
            "identifier": "102060",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE-RAILROAD",
            "identifier": "080071137",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "P89542",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "0120040",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kendall J Lee DDS PLLC
• Key Opportunities, Inc
• Cynthia Keyes
• Ronald Edward Kidd
• Keila K Kilgore, MA, NCC, LPC
• Dayanand Kiran, MS, PT
• Melissa Kirk
• Elizabeth Anne Klein, FNP
• Knapp Chiropractic Center PLLC
• David M. Knapp, D.C.

• Family Medicine Physician in Hillsdale, MI
• Providers in Hillsdale, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.