Individual provider Active NPI

Kimberly M Hassler, M.D.

  • Family Medicine Physician
  • Moscow, ID
National Provider Identifier
1629100870
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M-17284 Issued in ID
Practice address
803 S Main St Ste 120
Moscow, ID 83843-2695
Phone
(208) 848-8300
NPI assigned
Mar 12, 2007
Last updated
Jul 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 27022 SC
Family Medicine Physician 207Q00000X M-17284 ID Primary

Addresses

Primary practice location

803 S Main St Ste 120
Moscow, ID 83843-2695

Mailing address

611 N Iron Bridge Way
Spokane, WA 99202-4932
Phone (509) 444-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070625000025 SC Practitioner - Family Practice 3476652926 Reassigns benefits to 1 organization
I20230728001170 ID Practitioner - Family Practice 3476652926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Carolina School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1203 Idaho St
Lewiston, ID 83501-1940
Phone (208) 848-8300

803 S Main St
Moscow, ID 83843-2695
Phone (208) 848-8300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M-17284IDMDFamily Medicine Physician
27022SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Conner Chiropractic, LLC CurrentSince Nov 1, 2016 Accepting new patients
Community Health Association of Spokane Current Accepting new patients
Community Health Association of Spokane CurrentSince Aug 8, 2023 Accepting new patients
Lexington Health Inc Family Medicine CurrentSince Feb 1, 2021 Accepting new patients
Community Health Association of Spokane CurrentSince Aug 8, 2023 Accepting new patients
Lexington Health Inc Family Medicine Current Accepting new patients
Lexington Health Inc CurrentSince Feb 1, 2021 Accepting new patients
Community Health Association of Spokane Past Accepting new patients

Locations

1203 Idaho St
Lewiston, ID 83501
Phone (208) 848-8300

803 S Main St
Ste 120
Moscow, ID 83843
Phone (208) 848-8300

557 Columbia Ave
Chapin, SC 29036
Phone (803) 932-0655

7035 Saint Andrews Rd
Columbia, SC 29212
Phone (803) 749-0924

4080 Augusta Hwy
Gilbert, SC 29054
Phone (803) 892-1800

338 E Columbia Ave
Leesville, SC 29070
Phone (803) 332-4300

122 Powell Dr
Lexington, SC 29072
Phone (803) 957-8400

2006 Augusta Hwy
Lexington, SC 29072
Phone (803) 358-6400

716 Old Cherokee Rd
Lexington, SC 29072
Phone (803) 356-5526

811 W Main St
Lexington, SC 29072

811 W Main St
Ste 101
Lexington, SC 29072
Phone (803) 936-7230

811 W Main St
Ste 212
Lexington, SC 29072
Phone (803) 358-6180

935 W 2nd St
Swansea, SC 29160
Phone (803) 568-2000

2720 Sunset Blvd
West Columbia, SC 29169
Phone (803) 791-2480

611 N Iron Bridge Way
Spokane, WA 99202

Interoperability endpoints

  • Direct secure messaging: kimberly.hawkes.1@11411.direct.athenahealth.com

Organizations & group practices 8

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1629100870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 N IRON BRIDGE WAY",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992024932",
            "telephone_number": "509-444-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 S MAIN ST STE 120",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838432695",
            "telephone_number": "208-848-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSLER",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "27022",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-17284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moscow, ID

Sources for this page

Verify at the official NPI Registry.