Kimball C Atwood IV, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

47842 Issued in MA

Practice address

2014 Washington St
Dept of Anesthesia
Newton, MA 02462

Phone

(617) 243-6298

Fax

(617) 243-6184

NPI assigned

Jul 5, 2006

Last updated

Jun 16, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1861423345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 WASHINGTON ST",
            "address_2": "C/O PAR MGMT",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024621607",
            "telephone_number": "781-449-6150",
            "fax_number": "781-449-3970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 WASHINGTON ST",
            "address_2": "DEPT OF ANESTHESIA",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "02462",
            "telephone_number": "617-243-6298",
            "fax_number": "617-243-6184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATWOOD",
        "first_name": "KIMBALL",
        "middle_name": "C",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "47842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3010121",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Newton, MA
• Providers in Newton, MA by specialty
• Anesthesiology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; 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.