Individual provider Active NPI

Kimberly J Norris, M.D.

  • Ophthalmology Physician
  • Hastings, MI
National Provider Identifier
1659335305
Registry record updated Dec 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
43010539029 Issued in MI
Practice address
1761 W M-43 Hwy
Suite 1
Hastings, MI 49058-8378
Phone
(269) 945-3888
Fax
(269) 945-2112
NPI assigned
Apr 12, 2006
Last updated
Dec 9, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 43010539029 MI Primary

Addresses

Primary practice location

1761 W M-43 Hwy
Suite 1
Hastings, MI 49058-8378

Mailing address

1761 W M-43 Hwy
Suite 1
Hastings, MI 49058-8378
Phone (269) 945-3888

Other identifiers 1

IdentifierTypeStateIssuer
2692416MedicaidMI

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050927000859 MI Practitioner - Ophthalmology 4880651793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
State University of New York at Buffalo School of Medicine, 1984
Medicare assignment
May accept Medicare assignment
Group practices
Creekside Vision and Hearing, PLCGroup PAC ID 1355308263, 2 clinicians

Practice addresses (Care Compare)

1761 W M 43 Hwy
Suite 1
Hastings, MI 49058-8567
Phone (269) 945-3888

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.75 of 100Reported as group
Quality
91.5
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery71

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43010539029MIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Creekside Vision & Hearing, PLC CurrentSince Apr 29, 1997 Accepting new patients
Asthma Allergy Centers P.C. PastSince Sep 24, 2005 Accepting new patients
Pennock Hospital PastSince Jan 1, 2006 Accepting new patients

Locations

1761 W M 43 Hwy
Hastings, MI 49058
Phone (269) 945-3888

1761 W M 43 Hwy
Ste 1
Hastings, MI 49058
Phone (269) 945-3888

Organizations & group practices 4

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 1

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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481241600000",
    "number": "1659335305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1761 W M-43 HWY",
            "address_2": "SUITE 1",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490588378",
            "telephone_number": "269-945-3888",
            "fax_number": "269-945-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 W M-43 HWY",
            "address_2": "SUITE 1",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490588378",
            "telephone_number": "269-945-3888",
            "fax_number": "269-945-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORRIS",
        "first_name": "KIMBERLY",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2016-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "43010539029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2692416",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hastings, MI

Sources for this page

Verify at the official NPI Registry.