Active NPI
Kimberly H Everson, DVM
- Veterinarian
- Van Dyne, WI
National Provider Identifier
1346476983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Veterinarian
- License
- 6012-050
- Practice address
- N8545 Ridge Road
Van Dyne, WI 54979-9723 - Phone
- (920) 923-6608
- Fax
- (920) 322-0384
- NPI assigned
- Jun 10, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Veterinarian | 174M00000X | 6012-050 | WI | Primary |
Addresses
Primary practice location
N8545 Ridge Road
Van Dyne, WI 54979-9723
Mailing address
N8545 Ridge Road
Van Dyne, WI 54979-9723
Phone (920) 923-6608
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6012-050 | WI | MD | Veterinarian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308009600000",
"number": "1346476983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N8545 RIDGE ROAD",
"city": "VAN DYNE",
"state": "WI",
"postal_code": "549799723",
"telephone_number": "920-923-6608",
"fax_number": "920-322-0384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N8545 RIDGE ROAD",
"city": "VAN DYNE",
"state": "WI",
"postal_code": "549799723",
"telephone_number": "920-923-6608",
"fax_number": "920-322-0384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVERSON",
"first_name": "KIMBERLY",
"middle_name": "H",
"credential": "DVM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-10",
"last_updated": "2011-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "174M00000X",
"taxonomy_group": "",
"desc": "Veterinarian",
"state": "WI",
"license": "6012-050",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Van Dyne, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.