Kimberly A Pummill, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

4301070280 Issued in MI

Practice address

8384 Holly Rd
Suite 1
Grand Blanc, MI 48439-7335

Phone

(810) 606-7888

Fax

(810) 606-6864

NPI assigned

Jun 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1609817527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8384 HOLLY RD",
            "address_2": "SUITE 1",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391976",
            "telephone_number": "810-606-7888",
            "fax_number": "810-606-6864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8384 HOLLY RD",
            "address_2": "SUITE 1",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484397335",
            "telephone_number": "810-606-7888",
            "fax_number": "810-606-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUMMILL",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MI",
            "license": "4301070280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "0251130",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE",
            "identifier": "14465",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "6U4349",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4469908",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "0P13640",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL INSURANCE",
            "identifier": "300073509",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPLUS",
            "identifier": "0993473",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Ann Pruski, MD
• Sandra Ann Przybysz, MA, LPC
• Psychiatric Consultants of Grand Blanc PLLC
• Rishi Kailash Pularu
• Pulmonary Medicine and Sleep Specialists PC
• Pure Hart Senior Care LLC
• Abhijit Vitthal Purohit
• Lisa Ann Purrenhage, OTR
• Nathan Allen Quaderer, DO
• Jonathon Paul Quinlan, DO

• Plastic Surgery Physician in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Plastic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.