NPIMap

Organization Active NPI

KND Development 59 LLC

  • Hospitalist Physician
  • La Mirada, CA
National Provider Identifier
1710216049
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
KND DEVELOPMENT 59 LLC
Practice address
14900 Imperial Hwy
La Mirada, CA 90638-2172
Phone
(502) 596-7300
Fax
(502) 596-4150
NPI assigned
Dec 16, 2009
Last updated
Jul 1, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
KINDRED HEALTHCARE, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Authorized official

Name
Linda L Fisher
Title
DVP Revenue Cycle
Phone
(502) 596-7358

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X Primary

Addresses

Primary practice location

14900 Imperial Hwy
La Mirada, CA 90638-2172

Mailing address

680 S 4TH St
Louisville, KY 40202-2407
Phone (502) 596-7358

Other identifiers 1

IdentifierTypeStateIssuer
DG736BOtherCAMEDICARE

Other names 1

  • 4823 KH LA MIRADA Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100724000249 CA Part B Supplier - Clinic/Group Practice 3678602802 Receives reassigned benefits from 205 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Perris, CA; Baldwin Park, CA; Westminster, CA; West Covina, CA; Santa Ana, CA; San Leandro, CA; San Diego, CA; Rancho Cucamonga, CA…

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Vijayasree Paruchuri MD78 organizations share this tax ID, including this one
Part of
Presence Covenant Medical Center

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1260921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593561600000",
    "number": "1710216049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 S 4TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022407",
            "telephone_number": "502-596-7358",
            "fax_number": "833-501-9731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14900 IMPERIAL HWY",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906382172",
            "telephone_number": "502-596-7300",
            "fax_number": "502-596-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KND DEVELOPMENT 59 LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KINDRED HEALTHCARE, INC",
        "enumeration_date": "2009-12-16",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DVP REVENUE CYCLE",
        "authorized_official_telephone_number": "502-596-7358"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "DG736B",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "4823 KH LA MIRADA",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "4823 KH LA MIRADA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in La Mirada, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; 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.