Individual provider Active NPI

Kimberly Kinder, M.D.

  • Otolaryngology Physician
  • Chico, CA
National Provider Identifier
1376705111
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A142311 Issued in CA
Practice address
135 Mission Ranch Blvd Ste 100
Chico, CA 95926-2175
Phone
(530) 342-2411
Fax
(530) 894-5783
NPI assigned
Jul 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A142311 CA Primary

Addresses

Primary practice location

135 Mission Ranch Blvd Ste 100
Chico, CA 95926-2175

Mailing address

1967 Lawrence St
Klamath Falls, OR 97601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX, OR, WA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20160713001597 CA Practitioner - Otolaryngology 4183868193 Reassigns benefits to 1 organization
I20170614000906 TX Practitioner - Otolaryngology 4183868193 Reassigns benefits to 1 organization
I20190403002805 OR Practitioner - Otolaryngology 4183868193 Reassigns benefits to 1 organization
I20260415003270 WA Practitioner - Otolaryngology 4183868193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Enloe Medical CenterGroup PAC ID 9739092388, 330 clinicians
Public Hospital Dist No 1 SkagitGroup PAC ID 6800793522, 321 clinicians

Practice addresses (Care Compare)

135 Mission Ranch Blvd
Suite 100
Chico, CA 95926-2175
Phone (530) 342-2411

211 S 13TH St
Mount Vernon, WA 98274-4107
Phone (360) 814-5900

Hospital & facility affiliations

  • Skagit Valley Hospital Hospital, Mount Vernon, WA, CCN 500003
  • Enloe Health Hospital, Chico, CA, CCN 050039

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
142311CAMDMarriage & Family Therapist
A142311CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Enloe Medical Center CurrentSince Sep 9, 2019 Accepting new patients
Sky Lakes Medical Center Inc CurrentSince Feb 25, 2019 Accepting new patients
Sky Lakes Medical Center Inc CurrentSince Feb 25, 2019 Accepting new patients
Enloe Medical Center Otolaryngology CurrentSince Sep 9, 2019 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Jun 5, 2017 Accepting new patients
Enloe Medical Center Past Accepting new patients
Enloe Medical Center Past Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

4000 Ambassador Dr
Anchorage, AK 99508
Phone (907) 729-1900

2865 Daggett Ave
Klamath Falls, OR 97601
Phone (541) 833-6221

3000 Bryant Williams Dr
Klamath Falls, OR 97601
Phone (541) 274-2345

Interoperability endpoints

  • Direct secure messaging: kkinder49894@enloedirect.org

Organizations & group practices 8

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": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1376705111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1967 LAWRENCE ST",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "97601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 MISSION RANCH BLVD STE 100",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959262175",
            "telephone_number": "530-342-2411",
            "fax_number": "530-894-5783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINDER",
        "first_name": "KIMBERLY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-01",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A142311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

Verify at the official NPI Registry.