Phillip R Kingma, M.D.

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

01040487 Issued in IN

Practice address

12289 Hancock St Ste 34
Carmel, IN 46032-5888

Phone

(317) 815-8950

Fax

(317) 815-8951

NPI assigned

Mar 24, 2006

Last updated

Oct 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Interventional Pain Management

Education

University of Cincinnati College of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Pain Institute Center for Minimally Invasive Spine PCGroup PAC ID 5597718791, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15200/brand/1/csg/1/fhir/r4
• Direct secure messaging: phillip.kingma.1@15200.direct.athenahealth.com
• Direct secure messaging: phillip.kingma@1370.chartlogic.direct-ci.com

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.

• Midwest Pain Institute Center for Minimally Invasive Spine PC

  • Interventional Pain Medicine Physician
  • Carmel, IN
  • NPI 1497785273
  Medicare reassignment Care Compare group NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692

  Interventional Pain Medicine

  NPD (past)
• Rush Memorial Hospital

  dba RMH Healthcare Associates Rural Health Clinic

  • Rural Health Clinic/Center
  • Rushville, IN
  • NPI 1659935781
  NPD (past)

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1629038419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12289 HANCOCK ST STE 34",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325888",
            "telephone_number": "317-815-8950",
            "fax_number": "317-815-8951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12289 HANCOCK ST STE 34",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325888",
            "telephone_number": "317-815-8950",
            "fax_number": "317-815-8951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGMA",
        "first_name": "PHILLIP",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IN",
            "license": "01040487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "phillip.kingma.1@15200.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "12289 Hancock St Ste 34",
            "city": "Carmel",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460325888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Madeline King, RBT
• McKenzey King, OTR
• Natalie King
• Savannah Grace King, FNP-C
• Kingdom Maintenance Preservation Corp
• Melanie M Kingsley, M.D.
• Robert Mark Kinn, MD
• Nicole Kinnick, PTA
• Kinsey Chiropractic, PC
• Joy Lynne Kinsey-Green, DC

• Interventional Pain Medicine Physician in Carmel, IN
• Providers in Carmel, IN by specialty
• Interventional Pain Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.