NPIMap

Individual provider Active NPI

Kim M Fodor, MD

  • Internal Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1811924533
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35080924 Issued in OH
Practice address
7825 Laurel Ave
Cincinnati, OH 45243-2608
Phone
(513) 561-4811
Fax
(513) 561-2730
NPI assigned
Jun 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35080924 OH Primary

Addresses

Primary practice location

7825 Laurel Ave
Cincinnati, OH 45243-2608

Mailing address

7825 Laurel Ave
Cincinnati, OH 45243-2608
Phone (513) 561-4811

Other identifiers 1

IdentifierTypeStateIssuer
2468913MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071103000135 VT Practitioner - Internal Medicine 8022035138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
George Washington University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

140 Hospital Dr
Bennington, VT 05201-5010

140 Hospital Dr
Bennington, VT 05201-5018

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35080924OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwestern Vermont Medical Center Inc. Internal Medicine CurrentSince Jun 4, 2012 Accepting new patients
Southwestern Vermont Medical Center Inc. CurrentSince Jun 4, 2012 Accepting new patients
Apogee Medical Group Vermont PC Internal Medicine Past Accepting new patients
Trihealth Q LLC Internal Medicine Past Accepting new patients

Locations

140 Hospital Dr
Ste 116
Bennington, VT 05201
Phone (802) 447-1836

120 Hospital Dr
Bennington, VT 05201
Phone (802) 440-4077

100 Hospital Dr
Bennington, VT 05201
Phone (802) 447-4509

140 Hospital Dr
Ste 108
Bennington, VT 05201
Phone (802) 447-1191

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 10

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811924533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7825 LAUREL AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452432608",
            "telephone_number": "513-561-4811",
            "fax_number": "513-561-2730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7825 LAUREL AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452432608",
            "telephone_number": "513-561-4811",
            "fax_number": "513-561-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FODOR",
        "first_name": "KIM",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35080924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2468913",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.