Individual provider Active NPI

Kieran G Kammerer, MD

  • Pediatrics Physician
  • Augusta, ME
National Provider Identifier
1417923947
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
013530 Issued in ME
Practice address
6 E Chestnut St
Augusta, ME 04330-5758
Phone
(207) 623-2977
Fax
(207) 626-9374
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 013530 ME Primary

Addresses

Primary practice location

6 E Chestnut St
Augusta, ME 04330-5758

Mailing address

6 E Chestnut St
Augusta, ME 04330-5758
Phone (207) 623-2977

Other identifiers 1

IdentifierTypeStateIssuer
292020099MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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

Enrollment IDStateProvider typePAC IDDetails
I20070821000016 ME Practitioner - Pediatric Medicine 4486746542 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
013530MEMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainegeneral Medical Center CurrentSince Nov 1, 2013 Accepting new patients
Mainegeneral Medical Center CurrentSince Nov 1, 2013 Accepting new patients

Locations

442 Civic Center Dr
Augusta, ME 04330
Phone (207) 622-6319

6 E Chestnut St
Augusta, ME 04330
Phone (207) 626-1236

150 Dresden Ave
Gardiner, ME 04345
Phone (207) 621-9337

10 Water St
Ste 202
Waterville, ME 04901
Phone (207) 873-9846

149 North St
Waterville, ME 04901
Phone (207) 622-1959

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1417923947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 E CHESTNUT ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305758",
            "telephone_number": "207-623-2977",
            "fax_number": "207-626-9374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 E CHESTNUT ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305758",
            "telephone_number": "207-623-2977",
            "fax_number": "207-626-9374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMMERER",
        "first_name": "KIERAN",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "013530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292020099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, ME

Sources for this page

Verify at the official NPI Registry.