Individual provider Active NPI

Kevin A Kimm, D.O.

  • Family Medicine Physician
  • Fairmont, MN
National Provider Identifier
1831131580
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
50882 Issued in MN
Practice address
717 S State St
Suite 900
Fairmont, MN 56031-4469
Phone
(507) 238-4949
Fax
(855) 273-5489
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 50882 MN Primary

Addresses

Primary practice location

717 S State St
Suite 900
Fairmont, MN 56031-4469

Mailing address

717 S State St
Suite 900
Fairmont, MN 56031-4469
Phone (507) 238-4949

Other practice location 1

1820 Central Ave
Estherville, IA 51334-2409
Phone (712) 362-5236

Other practice location 2

412 6th St
Armstrong, IA 50514-7432
Phone (507) 238-4949

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Floyd County Memorial Hospital Commission Family Medicine Past Accepting new patients
Kevin Kimm DO,PC Family Medicine PastSince Jul 1, 2003 Accepting new patients
United Hospital District Inc. PastSince Oct 31, 2021 Accepting new patients

Organizations & group practices 3

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1831131580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 S STATE ST",
            "address_2": "SUITE 900",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314469",
            "telephone_number": "507-238-4949",
            "fax_number": "855-273-5489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 S STATE ST",
            "address_2": "SUITE 900",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314469",
            "telephone_number": "507-238-4949",
            "fax_number": "855-273-5489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1820 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Estherville",
            "state": "IA",
            "postal_code": "513342409",
            "country_code": "US",
            "telephone_number": "712-362-5236",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "412 6th St",
            "address_purpose": "LOCATION",
            "city": "Armstrong",
            "state": "IA",
            "postal_code": "505147432",
            "country_code": "US",
            "telephone_number": "507-238-4949",
            "fax_number": "507-238-3365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMM",
        "first_name": "KEVIN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "50882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.