NPIMap

Individual provider Active NPI

Kimberly J Humulock, DO

  • Internal Medicine Physician
  • Warwick, RI
National Provider Identifier
1831154574
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO00521 Issued in RI
Practice address
190 Commerce Dr
Warwick, RI 02886-2430
Phone
(401) 492-1597
Fax
(401) 921-5973
NPI assigned
Apr 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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 DO00521 RI Primary

Addresses

Primary practice location

190 Commerce Dr
Warwick, RI 02886-2430

Mailing address

190 Commerce Dr
Warwick, RI 02886-2430
Phone (401) 921-5970

Other identifiers 6

IdentifierTypeStateIssuer
7936235OtherRIAETNA HEALTH CARE
454709OtherPRTUFTS HEALTH PLAN
04-0336OtherRIUNITEDHEALTH CARE
407435OtherRIBLUE CHIP
22405-7OtherRIBLUE CROSS & BLUE SHIELD
9022405MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20050209000167 RI Practitioner - Internal Medicine 5799736526 Practice locations: Warwick, RI

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Nova Southeastern College of Osteo Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

190 Commerce Dr
Warwick, RI 02886-2430
Phone (401) 921-5970

Hospital & facility affiliations

  • Amedisys Home Health Care Home health agency, Warwick, RI, CCN 417036
  • Vna of Care New England Home health agency, Warwick, RI, CCN 417006
  • Concord Health Services Home health agency, Cranston, RI, CCN 417049
  • Saint Elizabeth Home Care (Cathleen Naughton Associates) Home health agency, Warwick, RI, CCN 417038
  • Vna of Care New England Hospice, Warwick, RI, CCN 411505
  • Kent County Memorial Hospital Hospital, Warwick, RI, CCN 410009
  • The Miriam Hospital Hospital, Providence, RI, CCN 410012
  • Women & Infants Hospital of Rhode Island Hospital, Providence, RI, CCN 410010
  • South County Hospital Inc Hospital, Wakefield, RI, CCN 410008
  • Westerly Hospital Hospital, Westerly, RI, CCN 410013

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
Dr. K. Humulock, Internal Medicine Inc. Internal Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: khumulock@direct.carene.org
  • Direct secure messaging: khumulock@kent.cernerdirect.carene.org

Organizations & group practices 2

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.

Hospital & facility affiliations 11

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1831154574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 COMMERCE DR",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862430",
            "telephone_number": "401-921-5970",
            "fax_number": "401-921-5973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 COMMERCE DR",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862430",
            "telephone_number": "401-492-1597",
            "fax_number": "401-921-5973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMULOCK",
        "first_name": "KIMBERLY",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-18",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "DO00521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HEALTH CARE",
            "identifier": "7936235",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "454709",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTH CARE",
            "identifier": "04-0336",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "407435",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "22405-7",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9022405",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.