Individual provider Active NPI

Rochelle Ann Kilmer

  • Child Mental Illness Respite Care
  • Tucson, AZ
National Provider Identifier
1780026047
Registry record updated Jul 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Mental Illness Respite CareTaxonomy code 385HR2055X
License
2975453 Issued in AZ
Practice address
12916 W Butter Bush St
Tucson, AZ 85743-7269
Phone
(520) 870-1213
NPI assigned
Jul 26, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child Mental Illness Respite Care 385HR2055X 2975453 AZ Primary

Addresses

Primary practice location

12916 W Butter Bush St
Tucson, AZ 85743-7269

Mailing address

12916 W Butter Bush St
Tucson, AZ 85743-7269
Phone (520) 870-1213

Other identifiers 1

IdentifierTypeStateIssuer
2975453OtherAZOLCR LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2975453AZMDChild Mental Illness Respite Care

NPI Registry JSON

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

{
    "created_epoch": "1374796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374796800000",
    "number": "1780026047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12916 W BUTTER BUSH ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857437269",
            "telephone_number": "520-870-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12916 W BUTTER BUSH ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857437269",
            "telephone_number": "520-870-1213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILMER",
        "first_name": "ROCHELLE",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-26",
        "last_updated": "2013-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": "AZ",
            "license": "2975453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OLCR LICENSE",
            "identifier": "2975453",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.