NPIMap

Individual provider Active NPI

Kimber M Gauthier, MD

  • Family Medicine Physician
  • Escanaba, MI
National Provider Identifier
1871587709
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301082649 Issued in MI
Practice address
610 S Lincoln Rd
Escanaba, MI 49829-1215
Phone
(906) 786-6488
NPI assigned
Sep 7, 2005
Last updated
Jul 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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 4301082649 MI Primary

Addresses

Primary practice location

610 S Lincoln Rd
Escanaba, MI 49829-1215

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7210

Other identifiers 3

IdentifierTypeStateIssuer
KG082649OtherMIBCBS OF MICHIGAN
P00064002OtherMIRAILROAD MEDICARE
4545812MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20031229000842 MI Practitioner - Family Practice 2264330257 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

610 S Lincoln Rd
Bellin Health
Escanaba, MI 49829-1215
Phone (906) 786-6488

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301082649MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc Family Medicine CurrentSince Jul 6, 2010 Accepting new patients
Sound Inpatient Physicians-Michigan, PLLC Family Medicine CurrentSince Jan 1, 2021 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Jul 6, 2010 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc Family Medicine Past Accepting new patients

Locations

610 S Lincoln Rd
Escanaba, MI 49829
Phone (906) 786-6488

440 Woodward Ave
Iron Mountain, MI 49801
Phone (906) 776-9040

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

Interoperability endpoints

  • Direct secure messaging: kgauthier32022@direct.thedacare.org
  • Direct secure messaging: kgauthiermarkovich917005@direct.emplifyhealth.org

Organizations & group practices 5

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 6

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": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1871587709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7210",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 S LINCOLN RD",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498291215",
            "telephone_number": "906-786-6488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUTHIER",
        "first_name": "KIMBER",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-07",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301082649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "KG082649",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00064002",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4545812",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Escanaba, MI

Sources for this page

Verify at the official NPI Registry.