Individual provider Active NPI

Kimberley Oliver, ARDM, RVT

  • Sonography Radiologic Technologist
  • Plymouth, MI
National Provider Identifier
1477607182
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sonography Radiologic TechnologistTaxonomy code 2471S1302X
License
8566 Issued in ND
Practice address
729 W Ann Arbor TRL
Ste.200
Plymouth, MI 48170-1631
Phone
(734) 414-7056
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sonography Radiologic Technologist 2471S1302X 8566 ND Primary

Addresses

Primary practice location

729 W Ann Arbor TRL
Ste.200
Plymouth, MI 48170-1631

Mailing address

15418 Oceana Ave
Allen Park, MI 48101-1956
Phone (313) 386-3814

Other names 1

  • Kimberley Ellen Buness Former name

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

LicenseStateTypeSpecialty
8566NDMDSonography Radiologic Technologist

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477607182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15418 OCEANA AVE",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481011956",
            "telephone_number": "313-386-3814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 W ANN ARBOR TRL",
            "address_2": "STE.200",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701631",
            "telephone_number": "734-414-7056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "KIMBERLEY",
        "name_prefix": "Mrs.",
        "credential": "ARDM, RVT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": "ND",
            "license": "8566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLEY",
            "last_name": "BUNESS",
            "middle_name": "ELLEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.