Individual provider Active NPI

Gerrit Anthony Kimmey, M.D.

  • Medical Oncology Physician
  • Huntington, WV
National Provider Identifier
1720192545
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
13870 Issued in WV
Practice address
5170 US Route 60
Huntington, WV 25705-2004
Phone
(304) 528-4645
Fax
(304) 697-0807
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 13870 WV Primary

Addresses

Primary practice location

5170 US Route 60
Huntington, WV 25705-2004

Mailing address

5170 US Route 60
Huntington, WV 25705-2004
Phone (304) 528-4645

Other identifiers 3

IdentifierTypeStateIssuer
0084318000MedicaidWV
0589126MedicaidOH
6407176MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address GerritKimmey@himg.directbygreenway.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20051228000022 WV Practitioner - Hematology/Oncology 4789606294

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13870WVMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ultimate Health Services, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: gerritkimmey@himg.directbygreenway.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1720192545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5170 US ROUTE 60",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257052004",
            "telephone_number": "304-528-4645",
            "fax_number": "304-697-0807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5170 US ROUTE 60",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257052004",
            "telephone_number": "304-528-4645",
            "fax_number": "304-697-0807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMMEY",
        "first_name": "GERRIT",
        "middle_name": "ANTHONY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "WV",
            "license": "13870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0084318000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0589126",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6407176",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "GerritKimmey@himg.directbygreenway.com",
            "affiliation": "N",
            "address_1": "5170 US Route 60",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257052004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.