NPIMap

Individual provider Active NPI

Kimberly Christine Capp, D.O.

  • Pediatrics Physician
  • Sitka, AK
National Provider Identifier
1386834539
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DO150950 Issued in OR
Practice address
222 Tongass Dr
Sitka, AK 99835-9416
Phone
(907) 966-2411
NPI assigned
Jul 25, 2007
Last updated
Dec 21, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO150950 OR
Internal Medicine Physician 207R00000X 100873 AK
Pediatrics Physician 208000000X DO150950 OR Primary
Pediatrics Physician 208000000X 100873 AK

Addresses

Primary practice location

222 Tongass Dr
Sitka, AK 99835-9416

Mailing address

511 Kinkead St
Sitka, AK 99835-7433
Phone (503) 739-3371

Other names 1

  • Kimberly Christine Carson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160308002690 TX Practitioner - Pediatric MedicinePractitioner - Internal Medicine 8123192051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1204 Seward Ave
Searhc 1204 Behavioral Health Sitka
Sitka, AK 99835-7359
Phone (907) 966-8611

1206 Seward Ave
Searhc 1206 Behavioral Health Sitka
Sitka, AK 99835-7359
Phone (907) 966-8611

1209 Seward Ave
Searhc 1209 Behavioral
Sitka, AK 99835-7359
Phone (907) 966-8611

222 Tongass Dr
Sitka, AK 99835-9416
Phone (907) 966-2411

227 Tongass Dr
Sitka, AK 99835-9416
Phone (907) 966-2411

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
100873AKMDPediatrics Physician
DO150950ORMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Alaska Regional Health Consortium Current Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince Jan 20, 2016 Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince Jan 20, 2016 Accepting new patients
Southeast Alaska Regional Health Consortium Past Accepting new patients
South East Alaska Regional Health Consortium Past Accepting new patients
South East Alaska Regional Health Consortium Past Accepting new patients
Southeast Alaska Regional Health Consortium Past Accepting new patients
South East Alaska Regional Health Consortium Past Accepting new patients
South East Alaska Regional Health Consortium Past Accepting new patients
Yakutat Tribal Health Board Past Accepting new patients
South East Alaska Regional Health Consortium Past Accepting new patients

Locations

37 Chilkat Ave
Haines, AK 99827
Phone (907) 463-4040

2000 Salmon Creek Ln
Juneau, AK 99801
Phone (907) 463-8700

3100 Channel Dr
Ste 300
Juneau, AK 99801
Phone (907) 463-4000

3260 Hospital Dr
Juneau, AK 99801
Phone (907) 796-8427

222 Tongass Dr
Sitka, AK 99835
Phone (907) 966-8423

Interoperability endpoints

  • Direct secure messaging: kimberlyc@direct-searhc.org

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1386834539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 KINKEAD ST",
            "city": "SITKA",
            "state": "AK",
            "postal_code": "998357433",
            "telephone_number": "503-739-3371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 TONGASS DR",
            "city": "SITKA",
            "state": "AK",
            "postal_code": "998359416",
            "telephone_number": "907-966-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPP",
        "first_name": "KIMBERLY",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-25",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "DO150950",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AK",
            "license": "100873",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "DO150950",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AK",
            "license": "100873",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "CARSON",
            "middle_name": "CHRISTINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sitka, AK

Sources for this page

Verify at the official NPI Registry.