Diana Therese Kitzmiller, MA, LLP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301010475 Issued in MI

Practice address

55 Maumee TRL
Lake Orion, MI 48362-1221

Phone

(248) 705-5986

NPI assigned

Apr 1, 2011

Last updated

Jul 17, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• John Kitzmiller M.D. PC

  dba Bald Mountain Behavioral Medicine

  • Addiction Medicine (Family Medicine) Physician
  • Lake Orion, MI
  • NPI 1518393800
  Medicare reassignment NPD

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374019200000",
    "number": "1588953335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 MAUMEE TRL",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483621221",
            "telephone_number": "248-705-5986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MAUMEE TRL",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483621221",
            "telephone_number": "248-705-5986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITZMILLER",
        "first_name": "DIANA",
        "middle_name": "THERESE",
        "name_prefix": "Ms.",
        "credential": "MA, LLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-01",
        "last_updated": "2013-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301010475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Ray Kibby
• Kids Tooth Team Lake Orion PLLC
• Shree Devi Kilaru, D.O.
• John David Kilmer, D.O.
• Beth Joy Kimmel, BA,CDF, SST
• John W Kitzmiller, MD
• Nancy Marie Kizer-Campbell
• Melissa Anne Klenczar, M.D.
• Calen Rylea Knight
• Faith Elizabeth Knop

• Psychologist in Lake Orion, MI
• Providers in Lake Orion, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.