Irene Kimivo Kimura, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00032544 Issued in WA

Practice address

821 E Broadway Ave
Suite 1
Moses Lake, WA 98837-5934

Phone

(509) 765-1602

Fax

(509) 766-9778

NPI assigned

Jun 23, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387324800000",
    "number": "1366448359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 E BROADWAY AVE STE 1",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988375934",
            "telephone_number": "509-765-1602",
            "fax_number": "509-766-9778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 E BROADWAY AVE",
            "address_2": "SUITE 1",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988375934",
            "telephone_number": "509-765-1602",
            "fax_number": "509-766-9778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMURA",
        "first_name": "IRENE",
        "middle_name": "KIMIVO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-23",
        "last_updated": "2013-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00032544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8178360",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael A Kegel, MA
• Kristine E Kehler, ARNP
• Brittany Ellen Kesten, PMHNP
• Cartney Michelle Kesten, ARNP
• Chloe Noel Kesterson, PA-C
• August Daniel King, MD
• Jocelyn King
• Katrina Elice King
• William King
• Candice Kingrey, MS

• Family Medicine Physician in Moses Lake, WA
• Providers in Moses Lake, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.