Michelle Dawn Kimmel, M.D.
Individual provider Active NPI Family Medicine Physician · Pawnee, OK
NPI 1528089505 · NPPES record last updated Nov 20, 2014
Key facts
- NPI
- 1528089505
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 17678 (OK)
- Practice address
- 1201 Heritage Cir
Pawnee, OK 74058-3744 - Phone
- (918) 762-2517
- Fax
- (918) 762-4614
- NPI assigned
- Jul 22, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Oklahoma College of Medicine, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pawnee Indian Health Center
Practice addresses (Care Compare)
1201 Heritage Cir
Pawnee, OK 74058-3744
Phone (918) 762-2517
Hospital & facility affiliations
- Lawton Indian Hospital
- Stillwater Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130927000307 | TX | Practitioner - Family Practice | 5890748008 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pawnee Indian Health Center | Current |
Accepting new patients | |
| Ahs Oklahoma Physician Group LLC | Family Medicine | Past | Accepting new patients |
| Pawnee IHS Pharmacy | Past |
Accepting new patients |
Locations
1201 Heritage Cir
Pawnee, OK 74058
Phone (918) 762-2517
Interoperability endpoints
- https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 17678 | OK | Yes |
Addresses
Primary practice location
1201 Heritage Cir
Pawnee, OK 74058-3744
Mailing address
1023 E Cherry St Ste a
Cushing, OK 74023-4105
Phone (918) 225-0771
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100195080C | Medicaid | OK |
Other providers in Pawnee, OK
- Ronnie E Jestes
- Brandi Dawn Johnson
- Brenna Lee Jones
- Eva L Jones
- Henry John Kaehler Jr.
- Becky Knight
- Gayle Ann Kostyack
- Gordon P Laird
- Jeanette Littlesun
- Jasha Lyons Echo-Hawk
All providers in Pawnee, OK · Family Medicine Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.